疑难配血患者红细胞输注无效的影响因素及预测模型的构建

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中图分类号：R457.1；R446.6 文献标志码：A DOI：10.3969/j. issn.1003-1383.2025.12.006

【Abstract】ObjectiveToanalyze theinfluencingfactorsof theefectofredbloodcelltransfusion inpatients with difficultblood matching，and to construct a prediction modelforthem.MethodsAretrospective analysis was conducted on theclinicaldataofO5patientswithdificultbloodmatchingadmitedtotheFirstPeople'sHospitalofQinzhou.Basedonthe fficacyofredbloodcelltransfusion，patients weredividedintoffetive group（55cases）andineffective group（5Ocases））. Differences ofindicatorssuchas generaldata，serologicalcharacteristics，blood biochemistry，ndroutinebloodtestbetween the twogroupswereanalyzedbyunivariateanalysis.Furthermore，multivariatelogisticregressionanalysiswasused to analyzetheriskfactorsofinefectiveredblodcelltransfusioninpatientswithdificultbloodmatching，andariskprediction modelforinefective transfusion was constructed.ResultsUnivariateresultsshowed thatthere were statisticallsignificant differences inage，transfusionhistory，fever，infection，blooddiseases，directantiglobulintest（DAT），antibodysreening， whiteblood cell count，hemoglobin，and total bilirubinbetween the two groups（ P<0.05 ）.Multivariate logistic regression analysis showed that transfusion history，fever，infection，positive antibody screening，andlow hemoglobin levels were independent influencing factorsfor inefectiveredbloodcelltransfusion inpatients with diffcult blood matching（ P<0.05 ）. Acolumnchartpredictionmodelforinefectiveredbloodcelltransfusioninpatientswithdiffcultbloodmatching was constructed.After verification，the AUC of this model was O.97O，which indicated that the prediction performance of this modelwas god.ConclusionAhistoryof transfusion，fever，infection，positive antibodyscrening，andlowhemoglobin levelsareasociatedwitharelativelyhighriskofineffctiveredbloodcelltransfusioninpatientswithdificultblood matching.Apredictivemodel constructedbasedontheserisk factorsprovidesascientific basis for the preventionandtreatment of ineffective transfusion in such patients.

【Keywords】diffcult blood matching；ineffectivered blood celltransfusion；influencing factors；prediction model

输血是将全血、血液成分或血液制品输入患者循环系统的治疗过程，以补充血容量、改善组织氧合及纠正凝血功能障碍的关键治疗手段，尤其在贫血、创伤、白血病等疾病中具有不可替代的作用。（剩余7422字）