辐照血临床应用的研究(1)
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[摘要] 目的：观察输注γ射线辐照血预防输血相关性移植物抗宿主病(TA-GVHD)以及输血后不良反应的发生及输血效果。方法：输血前对血制品用GWGP型钴-60远距离治疗机对准照射区的中心平面进行照射，照射剂量25 Gy。选择90例血液病患者输入辐照血作为辐照血组，同时选择90例常规输血的血液病患者作为对照组。结果：输注辐照成分血后血红蛋白(Hb)、红细胞计数(RBC)、血小板计数(PLT)均明显升高，与输注前比较，差异有统计学意义(P<0.05)。辐照血组输注后40 d未发生皮疹、腹泻、肝功损害。随访率为100%。全组病例按计划完成，完成率为100%。结论：γ射线辐照血可有效预防TA-GVHD的发生，可以达到与输注未经照射的等量血液成分同样的疗效。
[关键词] 辐照；γ射线；血液成分；疗效观察
[中图分类号] R457.1 [文献标识码] A [文章编号] 1673-7210(2011)11(c)-062-03
Clinical application of irradiated blood
SUN Xiaowei, GUO Hai, XIE Chunsheng, WANG Yuanyuan, CHEN Qi
Department of Radiation Oncology, the First Hospital of Fangshan District, Beijing 102400, China
[Abstract] Objective: To observe the irradiated blood effect on preventing TA-GVHD and adverse reactions of blood disease patients. Methods: The blood and its productions were irradiated with radial γ of 25 Gy by GWGP Co-60 machine before transfusing. 90 patients with blood disease who received irradiated blood were selected as irradiated blood group. At the same time, 90 patients who received normal blood transfusion were choosed as control group. Results: The Hb, RBC and PLT of all of the transfused irradiated blood group rose obviously, and there was a significant difference compared with before infusion (P<0.05). 40 days after infusion were not rash, diarrhea, liver damage. Follow-up rate was 100%. All the patients completed as planned, and the completion rate was 100%. Conclusion: The irradiated blood by radial-γ a credible method to prevent TA-GVHD, it can also reach the equal effect by transfusing the equal blood without irradiation.
[Key words] Irradiated; γ-Ray; Blood components; Efficacy observation
临床医师对输血引起的移植物抗宿主病了解较少，这种输血相关性移植物抗宿主病(TA-GVHD)发病急、病死率高。输血疗法在临床应用广泛，因此提高对TA-GVHD这一输血并发症的认识，预防其发生，有着重要临床意义。
1 资料与方法
1.1 一般资料
选取2004年11月~2007年11月我院放疗科与血库通过血型交叉配血及相关检查合格，并应用以钴-60为放射源的γ射线辐照血液成分的血液病放化疗180例住院患者，男100例，女80例；年龄3~75岁；再生障碍性贫血50例，急性白血病50例，恶性淋巴瘤80例。其中，输注机采浓缩血小板(15 U/例)50例，输注红细胞悬液(2 U/例)30例，输注全血100例；将其分为辐照血组和对照血组，每组各90例。两组性别、年龄等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。
1.2 方法
辐照血组：输血前对血制品用GWGP型钴-60远距离治疗机对准照射区的中心平面进行照射，照射剂量25 Gy。观察输成分血后的患者血红蛋白(Hb)、红细胞计数(RBC)、血小板计数(PLT)、辐照血与未辐照血储存天数、照射回输前后白细胞数量 ......
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