实用临床医药杂志2026，Vol.30Issue(4)：85-93,9.DOI:10.7619/jcmp.20246017
输血相关急性肺损伤危险因素的Meta分析
Meta-analysis of risk factors for transfusion-related acute lung injury
摘要
Abstract
Objective To systematically review the risk factors of transfusion-related acute lung injury(TRALI).Methods Observational studies on the risk factors of TRALI were retrieved from databases including PubMed,CINAHL,EMBASE,The Cochrane Library,CNKI,WanFang Data,VIP,and CBM from the establishment of the databases to March 2024.Quality assessment of the in-cluded studies was conducted.Two researchers independently screened the literatures and extracted data,and Meta-analysis was performed using RevMan 5.3 software.Results A total of 15 case-con-trol studies and 2 cohort studies were included,involving 9 489 patients.The results of the Meta-anal-ysis showed that:① Recipient-related factors included the Acute Physiology and Chronic Health Eval-uation(APACHE)score(SMD=0.45,95％CI,0.09 to 0.80,P=0.01),sepsis(OR=3.01,95％CI,1.66 to5.46,P=0.000 3),liver disease(OR=2.09,95％CI,1.25 to 3.50,P=0.005),and cardiopulmonary bypass time(WMD=83.71,95％ CI,12.00 to 155.42,P=0.002).(2)Transfusion-related factors(type/volume)included the volume of plasma(WMD=0.37,95％ CI,0.23 to 0.51,P＜0.000 01),the volume of plasma from female donors(WMD=0.32,95％ CI,0.02 to 0.62,P=0.04),fresh frozen plasma(FFP)(OR=2.62,95％ CI,1.72 to 3.98,P＜0.000 01),the volume of platelets(WMD=0.31,95％ CI,0.06 to 0.56,P=0.01),and mas-sive transfusion(＞10 U within 24 h)(OR=4.40,95％ CI,2.05 to 9.41,P=0.000 1).③ Do-nor-related factors included the content of palmitoyl lysophosphatidylcholine(Lyso-PC 16:0)/stearoyl lysophosphatidylcholine(LysoPC 18:0)(WMD=18.78,95％ CI,4.57 to 33.00,P=0.01),human leukocyte antigen class Ⅰ(HLA Ⅰ)antibodies(OR=13.77,95％ CI,1.13 to 167.28,P=0.04),and granulocyte antibodies(OR=4.48,95％ CI,1.54 to 13.04,P=0.006),which were significantly associated with TRALI.Conclusion The APACHE score,sepsis,liver disease,cardiopulmonary bypass time of recipients,the volume of infused plasma,the volume of plasma from female donors,infused FFP,the volume of infused platelets,massive transfusion,the content of Lyso-PC 16:0/LysoPC 18:0 in donations,the presence of HLA Ⅰ antibodies,and the presence of granulocyte antibodies in donations are factors influencing the occurrence of TRALI.关键词
输血相关急性肺损伤/败血症/体外循环时间/新鲜冰冻血浆/棕榈酰溶血卵磷脂/硬脂酰溶血卵磷脂/人类白细胞抗原/肝脏疾病Key words
transfusion-related acute lung injury/sepsis/cardiopulmonary bypass time/fresh frozen plasma/palmitoyl lysophosphatidylcholine/stearoyl lysophosphatidylcholine/human leuko-cyte antigen/liver disease分类
医药卫生引用本文复制引用
倪乐凤,朱强,解加泳,沈春华,刘林,喻静,刘雨露..输血相关急性肺损伤危险因素的Meta分析[J].实用临床医药杂志,2026,30(4):85-93,9.基金项目
江苏省卫生健康委2022年度医学科研立项[苏卫科教(2022)14号-228] （2022）
