输血患者及献血者红细胞血型同种不规则抗体发生频率的回顾性分析  

Retrospective analysis of the incidence of red cell irregular antibodies in the blood transfusion patients and donors

作　　者：林军[1] 戚小艳 王源[3] 

机构地区：[1]苏州大学附属第二医院输血科,江苏苏州215004 [2]宿迁市第一人民医院 [3]天津市疾病预防控制中心

出　　处：《中国输血杂志》2016年第10期1156-1158,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨患者及献血者人群中红细胞血型不规则抗体的发生频率及分布特点。方法收集本院临床红细胞标本32 496(人)份及献血者标本30 592(人)份,应用盐水法、试管抗球蛋白法、微柱凝胶法和各种血型定型试剂检定红细胞不规则抗体的特异性;调查红细胞不规则抗体患者的性别比例、有无输血史及妊娠史。结果本组红细胞血型不规则抗体筛选阳性率0.36%(230/63 080),其中同种抗体占93.04%(214/230),同种抗体+自身抗体0.43%(1/230),自身抗体占1.73%(4/230)例,未确定特异性的同种抗体占4.78%(11/230)。特异性抗体中,89.50%(196/219)来源于患者、发生频率0.31%(196/63 080),10.50%(23/219)来自献血者、发生频率0.04%(23/63 080)。结论患者不规则抗体发生频率明显高于献血者;为了避免患者免疫性输血反应的发生,减少献血者不规则抗体的输入,输血前全面开展红细胞同种免疫抗体筛检,对献血者血浆做次侧交叉配血,提高临床输血的安全性和有效性。Objective To discuss the incidence and characteristics of irregular antibodies on red cell blood group in the patients and donors. Methods All the blood samples of 32 946 patients and 30 592 donors were collected. The specificities of red cell irregular antibodies with the Brine method, antiglobulin test tube method, micro column gel and various blood typing reagents were analyzed. The gender ratio of red cell irregular antibodies, history of blood transfusion and history of pregnancy were analyzed. Results The positive rate of red cell irregular antibodies was 0.36% （230/63080） , among them homologous antibodies were 93.04% （214/230）, homologous antibodies and autoantibodies were 0. 43% （1/230） , autoantibodies were 1.73% （4/230）, homologous antibodies with undetermined specificity were 4.78% （11/230）. Among the specific antibodies, 89. 50% （196/219） came from the patients, the incidence was 0. 31% （196/63 080）, 10. 50% （23/219） came from the donors, the incidence was 0.04% （23/63 080）. Conclusion The incidence of red cell irregular antibodies in the patients is higher than the donors. In order to avoid the immune blood transfusion reaction, it is necessary to reduce the input of the irregular antibodies in the donors. Screening the red cell homologous antibodies and cross - match donors＂ plasma before blood transfusion can improve the effectiveness and safety of clinical blood transfusion.

关 键 词：红细胞血型 不规则抗体 抗体筛检 抗体鉴定 输血安全 

分 类 号：R457.11[医药卫生—治疗学]