同种抗体特异性不明确的81名患者血清学特征分析及红细胞输注效果评价  

Analysis of serological characteristics and efficacy of red blood cell transfusion in 81 cases of undefined specific alloantibody

作　　者：封彦楠 陈麟凤[1] 马春娅[1] 罗圆圆[1] 付丽辉[1] 汪德清[1] 

机构地区：[1]中国人民解放军总医院输血科,北京100853

出　　处：《中国输血杂志》2016年第12期1355-1358,共4页Chinese Journal of Blood Transfusion

基　　金："十三五"全军后勤科研项目子课题(BWS16J006)

摘　　要：目的对存在特异性不明确的同种抗体患者,通过分析血清学特征及评估红细胞输注效果,评价配血方法的安全性。方法回顾性分析本院2013-2014年度不规则抗体筛查阳性且血清学方法无法明确抗体特异性的患者139例,并应用临床输血智能管理与评估系统对81例输注红细胞的患者进行效果评价。结果 139例患者中,抗体类型分5种,效价低、活性弱抗体占多数。139例患者中红细胞输注81例,输注红细胞114次。其中输注有效率77.2%;部分有效率22.8%;输注无效率0%。不同类型抗体输注有效率与部分有效率无显著性差异(P>0.05)。81例输注红细胞患者中,男性34例,有输血史者19例(55.9%);女性47例,有输血史者43例(91.5%)。所有输血病例均无溶血性输血反应发生。结论红细胞输注前,不规则抗体筛查是必要的,尤应注意有输血史病例。即使血清学方法无法明确抗体特异性,必须同时用盐水法和微柱凝胶法做交叉配血试验,选择相合的血液输注。避免红细胞输注无效、输血不良反应的发生,节约血液资源,提高输血安全。Objective To analyze the serological characteristics, efficacy of red blood cell transfusion and safety of matching methods in patients with undefined specific allo-antibody. Methods The inpatients who needed blood transfusion in 2013 January to December 2014 were analyzed. There were 139 cases who were screened positive for irregular antibody. Serological methods could not be used to identify the specificity of the antibodies. Saline method and micro-column gel method were chosen to do the blood cross-matching test at the same time, and then the compatible blood was selected for transfusion. Clinical Blood Transfusion Intelligent Management and Evaluation System were applied to evaluate the efficacy of transfusion. Results The results showed that in 139 cases, five types of irregular antibody could be found. The majority of antibodies were low in titer and weak activity. The efficacy of red blood cell transfusion was analyzed： 81 cases were transfused with red blood cells in 139 patients in a total of 114 times. The effective rate was 77. 2%; the partially effective rate was 22. 8%; the ineffective rate was 0%. There was no significant difference in the effective rate of different types of antibodies （P〉0. 05）. In 81 patients, there were 19 in 34 （55.9%） males who had a history of transfusion and 43 in 47 （91.5%） females who had a history of transfusion. All the blood transfusion cases had no hemolytic transfusion reaction. Conclusion It is necessary to do irregular antibody screening before transfusion, especially in patients with a history of blood transfusion. Even if the speci- ficitv of the antibodies cannot be identified in serological method, saline method and micro-column gel method should be usedto do the blood cross-matching test at the same time in order to select the compatible blood to transfusion. It is important to avoid ineffective transfusion and adverse transfusion reaction, save blood resources, and improve the safety of blood transfusion.

关 键 词：非特异抗体 血清学特征 输注效果 

分 类 号：R457.11[医药卫生—治疗学] R331.141[医药卫生—临床医学]