无偿献血人群中已育女性HLA抗体筛查及特异性分析  

Identification of specificities of leucocyte alloantibodies in parous females among volunteer blood donors

作　　者：陈大伟[1] 夏文杰[2] 叶欣[2] 邓晶[2] 丁浩强[2] 李辉[3] 陈扬凯[2] 邵媛[2] 刘静[2] 王嘉励[2] 徐秀章[2] 高国全[1] 付涌水[2] 

机构地区：[1]中山大学中山医学院生物化学教研室,广东广州510080 [2]广州血液中心临床输血研究所 [3]广东食品药品职业学院生物技术学院

出　　处：《中国输血杂志》2014年第3期251-253,共3页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金(81102294);广东省自然科学基金项目(9151009505000002);广东省医学科研基金(B2013344);广州市医药卫生科技重点项目(20121A021021;20121A021020);广州市医药卫生科技一般项目(20131A011124);广州市科技计划项目(2012Y2-00024)

摘　　要：目的了解广州地区已育女性献血者中HLA-Ⅰ和Ⅱ类抗体的分布和特异性,评估这类献血者血液及其成分所含HLA抗体引起免疫性输血不良反应的风险。方法随机收集广州地区已育女性献血者标本343(人)份、未育女性献血者标本140(人)份,利用Lifecodes LifeScreen Deluxe(LMX)筛查标本的HLA抗体,阳性者再分别利用LIFECODES LSATMClassⅠ和LIFECODES LSATMClassⅡ鉴定抗体特异性。结果广州地区已育女性献血者中,抗-HLA阳性率25.07%(86/343),而未育女性献血者中抗-HLA阳性率3.57%(5/140)(P<0.05)。已育女性献血者中HLA-Ⅰ类抗体出现频率较高的分别是抗-A*11 28.8%(17/59)、抗-B*07 42.4%(25/59)和抗-Cw*07 20.3%(12/59),HLA-Ⅱ类抗体出现频率最高者是抗-DRB1*04 40.4%(19/47)。结论已育女性献血者HLA抗体出现的频率较高,这类献血者的血浆和单采血小板用于临床后势必增加HLA同种免疫反应的风险,应引起高度重视。Objective To elucidate the distribution of HLA-Ⅰ and HLA-Ⅱ antibodies in parous females among volun-teer blood donors in Guangzhou and identify the specificities of the HLA antibodies. To estimate the adverse reaction risks of immune-mediated blood transfusion due to HLA alloantibodies. Methods Randomly collect blood samples of 343 parous fe-males and 140 nulliparous females. Screen all samples with Lifecodes LifeScreen Deluxe （LMX）and carry out the antibody specificity detection in the positive samples with LIFECODES LSATMClass Ⅰ and LIFECODES LSATMClass Ⅱ （ Single Anti-gen）. Results Among the 343 parous females, the positive rate of HLA antibodies was 25.07% （ 86/343 ）, while the rate was only 3.57% （5/140） for nulliparous females （P 〈 0. 05 ）. The highest frequencies of HLA-Ⅰ alloantibodies were anti-A^ ＊ 11 28. 8% （17/59） ,anti-B ^＊ 07 42. 4% （25/59）, anti-Cw^ ＊ 07 20. 3% （12/59） ,while the most HLA-Ⅱ alloantibody was an-ti-DRB1^ ＊ 04 40. 4% （ 19/47 ） among the porous females. Conclusion The frequency of HLA alloantibodies in porous fe-males group is obviously higher than others. Using blood plasma and apheresis platelets of parous females will clearly increase the risk of alloimmunization.

关 键 词：献血者 已育女性 抗-HLA 抗体筛查 抗体特异性 同种免疫 输血反应 

分 类 号：R457.11[医药卫生—治疗学]