不规则抗体体内消减速率的研究  

The persistence and evanescence of red cell irregular antibody in vivo

作　　者：范亮峰[1] 刘曦[1] 沈伟[1] 金沙[1] 陆琼[1] 向东[1] 

机构地区：[1]上海市血液中心,上海200051

出　　处：《中国输血杂志》2016年第11期1229-1231,共3页Chinese Journal of Blood Transfusion

基　　金：上海市输血医学学科建设项目(编号:15GWZK0501)

摘　　要：目的通过回顾性研究红细胞血型不规则抗体在体内的消减,比较不同特异性不规则抗体的体内消减速率,探讨其特点,为输血相关不规则抗体检测提供参考和数据。方法研究2000-2016年上海地区存在不规则抗体的患者案例(不包括冷抗体,自身抗体和产前检查中发现的不规则抗体)。选择不同时间多次检测的患者,研究其输血史和不规则抗体强度变化,在考虑可比性的前提下,计算各类不规则抗体消减速率。根据不规则抗体检测中的凝集强度为抗体赋值(赋值方法参照AABB),结合检测间隔天数计算不规则抗体消减速率。结果共有110例不规则抗体具有多次检测的可比性数据(抗体特异性包括抗-E/-Ec,抗-Ce/-C,抗-D,抗-Jka,抗-Jkb,抗-Fyb,抗-Dia,抗-Wra,抗-M,抗-S),其中10%的不规则抗体在多次检测中逐渐消减至无法测得。Rh血型系统抗体在体内30 d(下同)平均消减速率0.259/30 d。非Rh血型系统抗体在体内平均消减速率:1.08/30 d。结论不同个体不规则抗体体内平均消减速率差异很大,Rh血型系统不规则抗体在体内平均消减速率低于其它血型系统抗体,由于其消减可能导致输血前检测的漏检和溶血性输血反应,临床输血应该重视对患者以往输血史、妊娠史,特别是以往不规则抗体检出史的了解。Objective Red cell irregular antibodies may become weak and undetectable over the course of time after transfusion-related alloimmunization. They can cause a delayed haemolytic reaction if the existence of antibodies was unknown before transfusion. So the research of persistence and evanescence of red cell irregular antibodies is valuable in theory,and can offer valuable data for safe transfusion. Only a few studies have been published on this topic. Methods In our research,We collected and detected the blood samples of patients from all of hospitals in Shanghai between 2000 and 2016. All warmreacting irregular antibodies were included,with the exception of ABO antibodies,cold-reacting antibodies,autoantibodies,antibodies produced in women of childbearing age. If the antibodies were tested again after the first detection,we recorded these antibodies data included the strength of antibodies,the length of follow-up,and calculated the rate of evanescence. Results We retrieved the records of 110 antibodies（ included anti-E / Ec,anti-Ce / C,anti-D,anti-Jka,anti-Jkb,anti-Fyb,antiDia,anti-Wra,anti-M,anti-S）,which had been tested again after the initial detection,and found that 10% of the antibodies became undetectable. The average rate of evanescence of Rh blood system antibodies（ 0. 259 / 30 days） is below the rate of evanescence of others blood system（ 1. 08 / 30 days）. Conclusion Red cell irregular antibodies commonly tend to disappear over the course of time,especially when they become weak and undetectable. The increased sensitivity of our current screening tests does not protect us against this risk. To avoid delayed haemolytic reactions,it is necessary to rely on previous records.

关 键 词：不规则抗体 抗体消减 凝集强度 抗体无法测得 RH抗体 非Rh抗体 

分 类 号：R457.11[医药卫生—治疗学]