MNS血型系统同种抗体的分布、性质与免疫史研究  

Clinical analysis of erythrocyte allo-antibodies to MNS blood group system

作　　者：刘婧婧[1] 王艳侠[1] 甘佳[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院输血科,100730

出　　处：《北京医学》2015年第11期1111-1113,共3页Beijing Medical Journal

摘　　要：目的探讨MNS血型系统同种抗体在我院抗体筛查试验阳性的发生率和临床意义。方法回顾性分析我院2013年6月至2015年4月抗体筛查试验阳性患者中存在MNS血型系统同种抗体患者的临床资料,对其输血史、妊娠史、疾病特点进行总结分析。结果对41 550例患者进行抗体筛查试验,阳性者509例(1.2%),其中69例(69/509,13.6%)为MNS血型系统同种抗体。在此69例中,抗-M 64例,占92.8%;抗-N 2例,占2.9%;抗-S 3例,占4.3%;平均年龄(46.2±16.9)岁,有妊娠史者22例(31.9%),有输血史者14例(20.3%)。结论由于Ig G性质的抗体可引起新生儿溶血病(HDN),故应在明确孕产妇抗体筛查实验中的抗体性质后,及时为患者选择抗原阴性的血液作为储备,以确保其输血安全。MNS血型系统同种抗体可通过输血刺激产生,对于反复输血及器官移植患者,应定期做抗体筛查实验,并保留其结果,当鉴定出有特异性的同种抗体时,应给予相应抗原阴性交叉配血相合血液,以保证输血的安全性。Objective To explore the occurrence and clinical significance of erythrocyte allo-antibodies to MNS blood group system among patients in Peking Union Medical College Hospital. Methods Clinical data of the anti-M positive patients from June 2013 to April 2015 were analyzed retrospectively. Their history of transfusion, history of gestation and disease features were reviewed. Results Among the 41 550 patients（12 748 male, 28 802 female） who accepted antibody screening experiments, 509 patients were antibody positive（509/41550, 1.2%, 124 male, 385 female）, of which 69（69/509,13.6%） were erythrocyte allo-antibodies to MNS blood group system. Among the 69 patients, 14 were male, 54 were female, 1 was newborn. Sixty- four patients were anti- M positive（64/69,92.8%）, 2 were anti- N positive（2/69,2.9%）, 3 were anti-S positive（3/69,4.3%）, and the average age was 46.2±16.9, 22 cases（22/69,31.9%） had history of gestation, 14 cases（14/69, 20.3%） had history of transfusion. Conclusion Erythrocyte allo-antibodies to MNS blood group system are frequently found in patients with history of transfusion or gestation. More attention should be paid to pregnant women when doing antibody screening experiments in order to protect their babies. Allo-antibodies to MNS blood group system could be stimulated by blood transfusion, so antibody screening tests should be taken regularly in patients who often receive blood transfusion or who receive organ transplant. Once the allo- antibodies are taken out, the consistency of cross-match blood without corresponding antigen should be checked to ensure the safety of blood transfusion. Communication with clinical doctors is also very important to make sure they are aware of the risk of transfusion and the transfusion is reasonable, so as to reduce the antibodies produced by transfusion.

关 键 词：抗体筛查 MNS血型系统 抗-M 抗-N 抗-S 新生儿溶血病 输血 

分 类 号：R446.6[医药卫生—诊断学]