妊娠期妇女红细胞血型不规则抗体检测和管理实践初探  

Preliminary exploration of irregular antibody testing and management in women during pregnancy

作　　者：肖洁 高守曦[1] 宋辉 朱晓艳[1] 丁汀 XIAO Jie;GAO Shouxi;SONG Hui;ZHU Xiaoyan;DING Ting(Department of Transfusion,Sichuan Provincial Hospital for Women and Children,Chengdu 610000,China)

机构地区：[1]四川省妇幼保健院,四川省妇女儿童医院输血科,四川成都610000

出　　处：《中国输血杂志》2020年第6期582-585,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨妊娠期妇女红细胞血型不规则抗体的检测时机、分布特征及其临床意义。方法选取2018年1月—2019年6月在本院产科门诊就诊的24 412名妊娠期妇女为研究对象,做不规则抗体筛查和鉴定,建立抗体阳性孕妇档案;回顾性统计分析不同妊娠期不规则抗体检测情况。结果本组妊娠妇女的不规则抗体阳性检出率0.88%(214/24 412);阳性检出率排在前3位的血型系统为Rh 0.37%(90/24 412)、Lewis 0.14%(35/24 412)和MNS 0.11%(26/24 412),3个系统中各自阳性检出率最高的抗体同为本组阳性检出率排在前3的抗体,即抗-E 0.25%(60/24 412)、抗-Lea 0.14%(33/24 412)、抗-M 0.1%(25/24 412)。随着妊娠或输血次数增加,抗体检出阳性率亦相应增加;本组69.63%(149/214)的抗体阳性者在妊娠中期(孕28周)前检出。结论妊娠期妇女规范开展不规则抗体检测,对于保障母婴健康及产科输血具有重要的临床意义。Objective To explore the detection timing, distribution characteristics and clinical significance of irregular antibodies in red blood cells of pregnant women. Methods From January 2018 to June 2019, a cohort of 24 412 antenatal attendances in our hospital were enrolled in this study, Irregular antibody screening and identification were performed, and the files of antibody-positive subjects were established. The irregular antibody monitoring results in different pregnancy periods was analyzed retrospectively. Results The overall prevalence of clinical significant antibodies in this cohort was 0.88%(214/24412). The irregular antibodies detected were mainly in blood systems as Rh(0.37%,90/24 412),Lewis(0.14%,35/24 412) and MNS(0.11%, 26/24412), with anti-E(0.25%,60/24412), anti-Lea(0.14%,33/24412)and anti-M(0.1%,25/24412)as the top 3 specificities of antibodies detected in each blood system.As the number of pregnancy or blood transfusion increased, the yield rate of irregular antibody increased accordingly. 149(69.63%) out of the 214 irregular antibody positive subjects were detected before the second trimester(28 weeks of gestation).Conclusion The routine antenatal antibody screening for Chinese women is worthwhile in safeguarding pregnancy outcome and obstetric blood transfusion.

关 键 词：不规则抗体筛查 妊娠期妇女 红细胞血型 胎儿新生儿溶血病 

分 类 号：R446.62[医药卫生—诊断学] R714.254[医药卫生—临床医学]