北京地区人群红细胞抗体免疫病患发生新增抗体的累积发生率  

Cumulative incidence of additional RBC antibodies in immunized groups of Beijing

作　　者：林裕翔 许志远[3] 蓝尹骏 李乃中 黃麗梅 张烨[3] 白艳丽 苗天红[3] LIN Yuxiang;XU ZhiYuan;LAN Yinjun;LEE Naizhong;HUANG Limei;ZHANG Ye;BAI Yanli;MIAO Tianhong(Department of Clinical Medi-cine,Peking University Health Science Center,Beijing 100191,China;Department of Clinical transfusion,Xian Internation-al Medical Center;Beijing Red Cross Blood Center)

机构地区：[1]北京大学医学部临床医学系,北京100191 [2]西安国际医学中心 [3]北京红十字血液中心

出　　处：《中国输血杂志》2019年第10期1021-1023,共3页Chinese Journal of Blood Transfusion

摘　　要：目的观察北京地区人群红细胞抗体免疫病患发生新增不规则抗体的累积发生率。方法2011-2014年北京地区98间不同规模医疗机构送往北京红十字血液中心血型室共551名病患。新增红细胞抗体定义是血型室已经报告为红细胞自身抗体或同种抗体且有二次以上输血纪录,在间隔3d以上的后续输血前检查发生交叉检查结果不相合且重新鉴定为新的不规则抗体。结束时间点(end point)则为最新一次输血纪录。时间轴(time axes)分别考虑输血的次数与单位。使用Kaplan-Meier方法评估新增红细胞抗体累积发生率,并利用年龄与性别进行累积发生率的分层分析。结果红细胞免疫患者的新增抗体累积发生率为输注2 U为0.55%、输注4 U为1.31%、输注6 U为1.78%、输注8 U为2.10%、输注10 U为2.52%、输注12 U为3.05%、输注14 U为3.73%;输注1次为0.55%、输注2次为1.82%、输注4次为2.33%、输注5次为3.07%、输注7次为4.24%。结论预防性Rh相合血型输血可显着降低约60%的新增抗体,若考虑增加S与Jk^b抗原相合,几乎可完全防止新增抗体发生。对于年长与女性是新增抗体的危险因子更应进行预防性输注。Objective Systemic investigation to cumulative incidence of additional RBC antibodies in immunized patients in Beijing are lacking.Methods From 2011 to 2014,blood samples from 551 patients were sent to the Blood Group Laboratory at the Beijing Red Cross Blood Center for antibody identification and matched blood component crossmatching.Cumulative incidence of additional antibodies was investigated by recording the observations of the patients who underwent crossmatching tests more than twice.The study outcomes were the results of the re-identification tests conducted because of the unmatched cross-matching results after the initial identification.Kaplan-Meier survival tables were used in the statistical analysis.Results The cumulative incidences of additional antibodies were 0.55%(after the first transfusion),1.82%(second time),2.33%(fourth time),3.07%(firth time),and 4.24%(seventh time).Similarly,the cumulative incidences of additional antibodies were 0.55%(after two units),1.31%(four units),1.78%(six units),2.10%(eight units),2.52%(ten units),3.05%(twelve units)and 3.73%(fourteen time).Conclusion Antibody against the Rh system was the most prevalent,followed by antibodies against S and Jk^b in immunized groups of Beijing.

关 键 词：累积发生率 意外抗体 同种免疫 

分 类 号：R457.11[医药卫生—治疗学]