红细胞血型不规则抗体与安全输血  

Irregular red blood cell antibodies and the safety of blood transfusion

作　　者：孔文兵[1] 赖福才[1] 彭道波[1] 王梁平[1] 赵晖[1] 杨新革[1] 陈春玲[1] 

机构地区：[1]南方医科大学南方医院输血科,广东广州510515

出　　处：《中国输血杂志》2014年第9期929-930,共2页Chinese Journal of Blood Transfusion

摘　　要：目的分析不规则抗体产生的频率及其特异性,探讨不规则抗体筛查阳性/配血不合的患者进一步的分析处理方法及有临床意义抗体的特异性鉴定,保证输血安全。方法对临床申请用/备血的患者常规进行3细胞不规则抗体筛查,并对抗体筛选阳性/配血不合的患者加做自身对照试验,根据试验的结果进一步选择抗体特异性鉴定方法。结果 2 821例患者标本中检出不规则抗体24例,阳性检出率0.85%;24例不规则抗体阳性标本中单纯自身抗体6例(25.0%);自身抗体+同种抗体3例(12.5%);单纯同种抗体15例(62.5%)。检出的同种抗体中抗-E 9例,抗-D 2例,抗-M 2例,抗-Lea2例,抗-A1、抗-Fyb、抗-Ec各1例。结论做好不规则抗体筛查与特异性鉴定对安全有效输血非常关键,结合自身对照试验,有助于甄别自身抗体、自身抗体合并同种抗体和单纯同种抗体的情况。Objective To analyze the frequency and specificity of the irregular antibody production;to investigate the irregular antibodies in the patients who screened positive and exhibited blood incompatibility ,followed by further analysis on the management methods and specific identification of the antibodies with clinical significance, in order to ensure the safety of blood transfusion. Methods Inthose patients who applied for clinical blood use,three cell irregular antibody screening were performed. In addition, those who screened positive and exhibited blood incompatibility were treated with either direct antiglobulin test or control methods. According to the test results, the specific antibody identification method was selected. Results Among the 2 821 patient specimens,24 cases of irregular antibodies were detected, with positive rate at O. 85%. Among the 24 cases tested positive for irregular antibody,there were 6 cases of simple autoantibodies （25%） ,3 cases of autoantibodies and isotype antibodies （12.5%） and 15 cases of alloantibodies（62.5% ）. Among the 15 cases consisting of alloantibodies, detection identified 9 anti-E cases,2 anti-D,2 anti-M,2 anti-Le, 1 anti-A1,1 anti-Fyb and 1 anti-Ec. Conclusion It is crucial to perform an irregular antibody screening and identification of antibody specificity in order to achieve a safe and effective blood transfusion. Combining this with the practice of self-control trials help to identify appropriate lycases containing autoantibodies, autoantibodies mixed with isotype antibodies, and simple alloantibodies.

关 键 词：不规则抗体 抗体特异性鉴定 输血安全 

分 类 号：R457.11[医药卫生—治疗学]