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백혈구 수혈에 관한 연구

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 (An) observation on the leukocyte transfusion 
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[한글] 백혈구 감소증 환자에서 항생제의 사용에도 불구하고 감염으로 인한 사망율은 매우 높다. 이에 저자는 1980년 9월부터 1981년 10월까지 연세의료원에 입원 가료중인 백혈구 감소증 환자들에게 과립백혈구 수혈을 시행해 본 결과 다음과 같은 결과를 얻었다. 1. 공혈자 100예를 대상으로 113회의 leukapheresis를 시행한 결과 공혈자의 혈액학적 소견상 Hct은 alternative bag method가 7%, simple bag method는 6.4%가 감소되어 유의한 차이가 없었으며(p>0.1) WBC는 두 방법 모두에서 증가하였다. 2. 공혈자 105예에서 120회의 백혈구 공혈을 시행한 결과 19회(15.8%)에서 감각이상, 오한등의 부작용이 관찰되었으나 대부분 별 문제가 없었으며 두 방법간의 유의한 차이가 없었다(p>0.05). 3. Yield면에서는 백혈구 농축액의 백혈구수가 alternative bag method에서는 1.374 × 10**10, simple bag method는 0.957 × 10**10으로 전자의 방법이 유의하게 좋았으며(p<0.05), 백혈구 농축액의 과립백혈구도 전자가 70.3%였고 후자는 55.3%였다. 4. 35예의 백혈구 감소증 환자에서 체온의 변화는 수혈전 평균체온이 38.1 ± 1.0℃, 수혈후가 .37.7 ± 0.9℃로 백혈구 수혈이 해열작용을 하였다고 볼 수 있는 유의한 차이가 있었다(p<0.01). 과립백혈구의 증가는 수혈전의 과립백혈군 수가 215.8±257.3/㎕ 수 혈후가 346.4±374.4/㎕로 통계적 의의는 었으나(p>0.05), 17예의 30회중 19회에서 증가하였다. 연구기간중 생존은 21예, 사망은 14예였다. 5. 이들 환자에서 검출된 세균중 감염원인균으로 추정된 것은 대부분 gram음성균이었으며 E. coli가 6예, A. calcoaceticus가 5예, S. aureus가 5예로 많았다. 감염병소는 패혈증 9예로 가장 많았고 폐염 농양 편도선염등이었다. 6. 수혈로 일한 alloimmunization에 대한 lymphocytotoxicity 검사를 실시한 11예중 5예는 양성, 6예는 음성을 나타내었으나 이 2군 환자의 임상적인 소견에는 유의한 차이는 없었다.
[영문] Though the use of appropriate antibiotics in granulocytopenic patients, the mortality from infection is high. Therefore, an analysis of the clinical effects of leukocyte transfusions was made on granulocytopenic patients at Yonsei University Medical College from September 1980 to October 1981. Following results were obtained. 1. As a result of 113 leukapheresis on 100 donors they showed 7% decrease of Hct by alternative bag method and 6.4% by simple bag method. There was no significant difference between these two methods(P>0.1). In both methods, they showed a considerable in-crease of WBC counts after leukapheresis. 2. Out of 12O times of leukapheresis on 105 donors, there developed a transient paresthesia and chill on 19 occasions(15.8%) as the major complications, but no further serious problems were observed. As to these complications, there was no significant difference between fore-mentioned two methods (P>0.05). 3. In alternative bag method, 1.374 x 10**10 leukocytes were yielded, among which 70.3% were granulocytes. In simple bag methods 0.957 x 10**10 leukocytes were yielded, among which granulocytes were 55.3%. As to the granulocyte yields, the former method was definitely superior than the latter method(P<0.05). 4. The average body temperature of pre-transfusion patients was 38.1±1.0℃, which was reduced to 37.7±0.9℃ after the transfusion. The difference was statistically significant(P<0.01). The average circulating granulocyte counts of pre-transfusion patients was 215.8±257.3/μl, which was elevated to 346.4±374.4/μl after the transfusion. But the difference was statistically insignificant(P>0.05). Despite of such statistical analysis, there were 19 granulocyte transfusions out of 30 trials(on 17 patients) in which actual increment of circulating granulocyte were achieved. Throughout the experiment, 21 patients survived and 14 died. 5. Among the infections organisms in granulocytopenic patients, the most common one was E. coli (6 cases), and the most common type of infection was septicemia (9 cased). 6. Following the transfusions, some of the patients developed alloimmunizations. Namely, out of 11 patients 5 were positive in lymphocytotoxicity test and the rest negative. Between these two groups, there was no difference in clinical pictures.
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Yonsei Authors
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
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