拟输血患者不规则抗体筛查结果分析  

Analysis of screening results of irregular antibodies in patients receiving blood transfusion

作　　者：秦华 程菲 朱梅[1] 高小文[1] 张小琦 胡江[1] 王宝燕[2] 徐华[3] QIN Hua;CHENG Fei;ZHU Mei;GAO Xiaowen;ZHANG Xiaoqi;HU Jiang;WANG Baoyan;XU Hua(Hanzhong Central Hispital,Hanzhong 723000, China;The First Affiliated Hospital of Xi’an Jiaotong University;Blood Center of Shaanxi Province)

机构地区：[1]汉中市中心医院,陕西汉中723000 [2]西安交通大学第一附属医院 [3]陕西省血液中心

出　　处：《中国输血杂志》2019年第6期560-564,共5页Chinese Journal of Blood Transfusion

摘　　要：目的了解红细胞血型不规则抗体在拟输血患者中的分布特证,确保临床输血的安全有效。方法选择本院临床用血科室2016年1月-2017年11月拟输血的7 500名患者,采用卡式微柱凝集法做不规则抗体筛查,将其中阳性者送往陕西省血液中心血型参比实验室以盐水法和抗球蛋白法鉴定不规则抗体特异性。对特异性抗体的种类、占比做统计分析,比较其在不同性别、不同病种的差异。结果本组拟输血患者不规则抗体阳性筛查率0.40%(30/7 500)。其中自身抗体占10%(3/30)、同种特异性抗体占90%(27/30)。按血型系统分,Rh抗体占63.33%(19/30)、Lewis抗体占6.67%(2/30)、MNS与Diego抗体各占3.33%(1/27),Rh混合Kidd抗体占6.67%(2/30)、Rh混合Kidd及MNS抗体占3.33%(1/30))、Rh混合自身抗体占3.33%(1/30)。就Rh系统而言,抗-E阳性率33.33%(10/30)最高,其他依次为抗-Ce[20%(6/30)]、抗-D[13.33%(4/30)];检出1例罕见抗-JK^3。男、女性不规则抗体阳性率为0.25%(9/3 626)vs 0.54%(21/3 874)(P<0.05)。从临床科室看,本组中不规则抗体阳性患者中以妇产科[43.33%(13/30)]、肿瘤科[20.00%(6/30)]占绝大多数。30名不规则抗体阳性患者中,20名匹配到无相应抗原配血相合的血液,其中16名输注了相应血液,并达到了有效的治疗目的。结论住院拟输血患者中出现的不规则抗体阳性以Rh系统抗体占多数,女性高于男性。临床在做不规则抗体的筛查同时增加Rh(CcEe)抗原项目的检测并确保同型输血,将为临床治疗提供安全、有效的血液并降低患者不规则抗体的产生。Objective To study the distribution of irregular antibodies of RBC blood type in patients receiving blood transfusion to ensure the safety and effectiveness of clinical blood transfusion. Methods A total of 7 500 patients who underwent blood transfusion from January 2016 to November 2017 in our clinical departments were enrolled in the study. The card type microcolumn agglutination method was used for irregular antibody screening, and the positive samples were sent to the Reference Laboratory, Blood Center of Shaanxi Province for further identification of the specificity of irregular antibody using saline method and anti-human globulin method. Statistical analysis was performed on the types and proportions of specific antibodies, and the differences among different sexes and diseases were compared. Results The screening rate of positive irregular antibodies in patients receiving blood transfusion was 0.40%(30/7 500). Among them, autoantibodies accounted for 10%(3/30) and allospecific antibodies accounted for 90%(27/30). According to the blood group system, Rh antibody accounted for 63.33%(19/30), Lewis antibody accounted for 6.67%(2/30), MNS and Diego antibody each accounted for 3.33%(1/27), and Rh antibody complicated with Kidd antibody accounted for 6.67%(2/30), Rh antibody complicated with Kidd and MNS antibodies accounted for 3.33%(1/30)), and Rh antibody complicated with autoantibodies accounted for 3.33%(1/30). For Rh system, positive rate of anti-E was 33.33%(10/30), followed by anti-Ce(20%,6/30) and anti-D(13.33%,4/30). One case of rare anti-JK^3 was detected in this study. The positive rate of irregular antibodies in male and female patients was 0.25%(9/3626) and 0.54%(21/3874)(P<0.05). As to the clinical department, the majority of patients with positive irregular antibody were from Obstetrics & Gynecology Department(43.33%, 13/30), and Oncology Department(20%, 6/30). Of the 30 irregular antibody positive patients, 20 was matched with blood without the corresponding antigen, and 16 of them received such

关 键 词：血型不规则抗体 Rh系统抗体 住院患者 抗-E 抗-CE 抗-Jk^3 

分 类 号：R457.11[医药卫生—治疗学] R446.62[医药卫生—临床医学]