摘要【目的】探讨冷沉淀血浆输注治疗急性消化道大出血的止血效果及其对T细胞亚群水平的影响。【方法】选取本院2015年12月至2018年12月收治的急性消化道大出血患者140例,根据随机数表法分成观察组和对照组,每组70例。两组均给予常规对症处理,对照组输注新鲜冰冻血浆,观察组输注冷沉淀血浆。比较两组临床止血效果,并记录两组患者的输注后的红细胞量、住院时间等指标。分别在治疗前、治疗后采集血液标本,经流式细胞检测仪测定两组T细胞亚群水平,包括CD3+、CD4+、CD8+、CD4+/CD8+,并记录两组不良反应发生率。【结果】观察组(95.71%)总有效率较对照组(85.71%)显著增高( χ2 =4.155, P <0.05)。观察组的输注后的红细胞量显著低于对照组,住院时间显著短于对照组( P <0.05)。两组治疗后CD3+、CD4+、CD4+/CD8+均显著低于治疗前,CD8+高于治疗前( P <0.05)。观察组治疗后CD3+、CD4+、CD4+/CD8+仍显著高于对照组,CD8+显著低于对照组( P <0.05)。两组非溶血性发热、过敏、含铁血黄素沉着症发生率比较无统计学意义( P >0.05)。【结论】冷沉淀血浆输注能减少输注后的红细胞量,缩短止血时间、住院时间,减轻输血后免疫抑制,未增加不良反应率,安全性高,总体疗效显著。
Abstract：【Objective】To investigate the hemostatic effect of cryoprecipitated plasma infusion in the treatment of acute gastrointestinal hemorrhage and its influence on the level of T cell subsets.【Methods】A total of 140 patients with acute gastrointestinal hemorrhage admitted to our hospital from December 2015 to December 2018 were divided into the observation group ( n =70) and the control group ( n =70) according to random number table method. Both groups were given routine symptomatic treatment.The control group was infused with fresh frozen plasma, while the observation group was given cryoprecipitated plasma infusion. The clinical hemostatic effect of the two groups was compared, and the red blood cell volume and hospital stay of the two groups were recorded. Blood samples were collected before and after treatment. T cell subsets including CD3+, CD4+, CD8+, CD4+/CD8+, were measured by flow cytometry. The incidence of adverse reactions was recorded. 【Results】The total effective rate of the observation group (95.71%) was significantly higher than that of the control group (85.71%) ( P <0.05).The amount of erythrocyte transfusion in the observation group was significantly lower than that in the control group, and the time of hemostasis and hospitalization was significantly shorter than that in the control group ( P <0.05).After treatment, CD3+, CD4+, CD4+/CD8+ in both groups were significantly lower than those before treatment, and CD8+ was higher than that before treatment ( P <0.05).After treatment, CD3+, CD4+, CD4+/CD8+ in the observation group were still significantly higher than those in the control group, and CD8+ was significantly lower than those in the control group ( P <0.05).There was no significant difference in the incidence of non-hemolytic fever, allergy and hemosiderinosis between the two groups ( P >0.05). 【Conclusion】Cryoprecipitated plasma infusion can reduce the amount of red blood cells after transfusion, shorten the time of hemostasis and hospital stay, reduce post transfusion immunosuppression, without increasing the rate of adverse reactions, with high safety and significant overall efficacy.
任姣雪, 邓蕾. 冷沉淀血浆输注治疗急性消化道大出血的止血效果及其对T细胞亚群水平的影响[J]. 医学临床研究, 2021, 38(3): 392-395.
REN Jiao-xue, DENG Lei. Hemostatic Effect of Cryoprecipitated Plasma Infusion on Acute Gastrointestinal Hemorrhage and Its Effect on T cell Subsets. JOURNAL OF CLINICAL RESEARCH, 2021, 38(3): 392-395.
2021, Vol. 38 
