无偿献血者不规则抗体分布及输血安全分析  

Irregular antibody distribution and blood transfusion safety in unpaid blood donors

作　　者：郭萍莉 Guo Pingli(Department of Blood Transfusion,Central Blood Station of Xiangyang,Shaanxi 712000,China)

机构地区：[1]陕西省咸阳市中心血站输血科,712000

出　　处：《山西医药杂志》2020年第11期1333-1335,共3页Shanxi Medical Journal

摘　　要：目的对无偿献血者不规则抗体分布及输血安全进行了研究。方法纳入咸阳市中心血站招募的无偿献血者304794例,对血液样本进行不规则抗体筛查。对无偿献血者不规则抗体阳性率,不规则抗体的效价、分布特征及类型进行分析。结果不规则抗体阳性142例,不规则抗体阳性率0.05%。其中IgG抗体38例(26.8%),IgM抗体101例(71.1%),同时具有IgM和IgG抗体阳性者3例(2.1%)。男性不规则抗体阳性率明显低于女性(P<0.05),男性不规则抗体分布与女性相比,差异无统计学意义(P>0.05)。142例不规则抗体阳性无偿献血者中,未确定特异性73例,占比最高,为51.4%,其次为Rh血型系统45例,占比达31.7%,MNS血型系统14例(9.9%),效价范围2~64。抗体特异性中,抗-D占比最高,为22.5%;其次为抗-M,为9.9%;随后为抗-E,占比8.5%。抗体性质中,抗-E、抗-Ce、抗-M、抗P1和自身冷抗体均为IgM,抗-D均为IgG,未确定特异性、多特异性抗球蛋白中IgG和IgM兼具。结论通过对无偿献血者不规则抗体进行筛查,了解地区不规则抗体的分布特征,对于提高临床输血安全具有重要意义。对于不规则抗体呈现阳性的血液制品,不宜将之应用于临床血液输注中,而可通过制备为洗涤红细胞或抗体血清等方式进行应用,减少血液的浪费。Objective To study the irregular antibody distribution and blood transfusion safety of unpaid blood donors.Methods A total of 304794 unpaid blood donors were recruited from the central blood station in Xianyang.The positive rate of irregular antibodies,the titer,distribution characteristics and types of irregular antibodies were analyzed.Results Irregular antibody was positive in 142 cases,and the positive rate of irregular antibody was 0.05%.Among them,38 were IgG antibodies(26.8%),101 were IgM antibodies(71.1%),and 3 were positive for both IgM and IgG antibodies(2.1%).The positive rate of irregular antibodies in males was significantly lower than that in females(P<0.05),and the distribution of irregular antibodies in males was not significantly different from that in females(P>0.05).Of the 142 irregular antibody-positive unpaid blood donors,73 had not been identified for specificity,the highest proportion being 51.4%,followed by Rh cases with 45 cases,accounting for 31.7%,and 14 cases with MNS systems(9.9%).Price range is 2-64.Among antibody specificities,anti-D accounted for 22.5%,followed by anti-M with 9.9%,followed by anti-E with 8.5%.Among the antibody properties,anti-E,anti-Ce,anti-M,anti-P1,and auto-cold antibodies are all IgM,and anti-D are all IgG.Specificity and multi-specific antiglobulin have not been determined to have both IgG and IgM.Conclusion It is of great significance to improve the safety of clinical blood transfusion by screening irregular antibodies of unpaid blood donors and understanding the distribution characteristics of irregular antibodies in the region.Blood products that are positive for irregular antibodies should not be used in clinical blood transfusion,but can be applied by washing red blood cells or antibody serum to reduce the waste of blood.

关 键 词：供血者 不规则抗体 输血 溶血作用 

分 类 号：R457.1[医药卫生—治疗学]