中国输血杂志2025，Vol.38Issue(10)：1348-1354,7.DOI:10.13303/j.cjbt.issn.1004-549x.2025.10.008
全血置换联合淋巴血浆置换治疗难治性自身免疫性溶血性贫血的临床疗效
Clinical efficacy of therapeutic whole blood exchange combined with lymphoplasmapheresis in refractory autoim-mune hemolytic anemia
王刚 1高旖鑫 1吴林燕 1潘柳燕 2何苏英 1周丽娟 3彭永正 1杨明会1
作者信息
- 1. 南方医科大学珠江医院 输血医学科,广东 广州 510220
- 2. 柳州市人民医院 输血科,广西 柳州 545006
- 3. 南方医科大学珠江医院 血液内科,广东 广州 510220
- 折叠
摘要
Abstract
Objective To evaluate the safety and efficacy of therapeutic whole blood exchange combined with lym-phoplasmapheresis in the treatment of refractory autoimmune hemolytic anemia(AIHA).Methods A retrospective analy-sis was performed on the clinical data of AIHA patients who underwent therapeutic whole blood exchange combined with lym-phoplasmapheresis at our hospital from March 2022 to May 2025.Efficacy was assessed by comparing changes in hemoglo-bin,platelet count,and bilirubin levels before and after treatment.Safety was evaluated by analyzing vital signs before and after the procedure,parameters during the exchange,and adverse reactions.Results A total of 12 AIHA patients were en-rolled,completing 19 exchange procedures.The number of procedures per patient ranged from 1 to 3.The median treatment duration was 67(65-73)minutes,with a median exchange volume of 2 025(1 851-2 121)mL,comprising 4.5(4-6)units of red blood cells and 1 350(1 200-1 400)mL of plasma.Ten patients achieved partial remission,one achieved complete remission,and one showed no response,yielding an response rate of 91%(11/12).After a single session,hemo-globin increased significantly by 17.58±9.85 g/L(P<0.01),while platelets counts decreased by 45(17.5,79)×109/L(P<0.05),and both systolic and diastolic blood pressure showed a significant elevation(P<0.05).However,no statisti-cally significant differences were observed in total bilirubin,indirect bilirubin,white blood cell count,or heart rate.During the procedures,4 adverse reactions occurred in 3 patients:one child experienced severe heart rate fluctuation twice consec-utively,and two adults developed plasma allergies.All reactions resolved spontaneously without pharmacological interven-tion.Conclusion The combination of therapeutic whole blood exchange and lymphoplasmapheresis appears to be a safe and effective treatment for refractory AIHA patients.关键词
难治性自身免疫性溶血性贫血/全血置换/淋巴血浆置换/糖皮质激素Key words
refractory autoimmune hemolytic anemia(AIHA)/therapeutic whole blood exchange/lymphoplasmaphere-sis/glucocorticoids分类
临床医学引用本文复制引用
王刚,高旖鑫,吴林燕,潘柳燕,何苏英,周丽娟,彭永正,杨明会..全血置换联合淋巴血浆置换治疗难治性自身免疫性溶血性贫血的临床疗效[J].中国输血杂志,2025,38(10):1348-1354,7.
