免疫关联缺陷导致临床血液收回的回顾性分析  

Retrospective analysis of blood product recalls due to immunohematology defects

作　　者：徐芳[1] 裴玲珍 洪帆 郑茵红[1] 李阿中[1] 陈峰[1] 李殷芳 许先国[1] XU Fang;PEI Lingzhen;Hong Fan;ZHENG Yinhong;LI Azhong;CHEN Feng;LI Yinfang;XU Xianguo(Blood Center of Zhejiang Province,Hangzhou 310052,China)

机构地区：[1]浙江省血液中心,浙江杭州310052

出　　处：《中国输血杂志》2020年第11期1179-1182,共4页Chinese Journal of Blood Transfusion

基　　金：国家卫生健康委科研基金(WKJ-ZJ-2021);浙江省卫生创新人才项目和省公益技术项目(LGF19H080004);浙江省医药卫生项目(2019KY369)。

摘　　要：目的分析免疫关联缺陷导致临床血液收回情况,为提高临床用血安全性提供研究数据。方法收集本中心2014-2019年免疫血液学缺陷血液收回的资料,统计分析血液收回率、收回原因、对应献血者信息和异常免疫血液学结果重复性。结果红细胞类血液成分6年供应量合计149万单位(U),其中因免疫血液学缺陷申请收回133袋(0.89袋/万U);确认后实际收回88袋(0.59袋/万U)。申请收回的血液中,DAT阳性占比最高(64.7%,86/133),45-55y献血者的血液收回率(2.52E-4)高于其他的低年龄段(1.22E-4-1.42E-4),女性献血者血液收回率(2.27E-4)高于男性献血者(1.06E-4)。在申请血液收回对应的79名重复献血者中,仅3名献血者检出多次免疫血液学异常。结论免疫血液学缺陷血液收回以DAT阳性为主,但总体收回率较低。从成效比计,不建议额外增加对所有献血者的DAT普筛程序。Objective To analyze the recall of blood products due to immunohematology defects and provide research data for improving clinical blood safety. Methods The data of blood product recalls due to immunohematology defects from 2014 to 2019 were collected. The frequency and reasons of blood product recall, information of corresponding donors and the repeatability of abnormal immunohematology results were statistically analyzed. Results The total supply of red blood cell components from 2014 to 2019 was 1.49 million units(U), of which 133 bags(0.89 bags/10 000 U) were involved in withdrawls due to immunohematology defects, and 88 bags(0.59 bags/10 000 U) were formally recalled after reconfirmation. The most common reason for recall requests was DAT-positive(64.7%,86/133). The recall rate(2.52 E-4) of blood donors aged 45-55 was higher than that of other low-age groups(1.22 E-4 to 1.42 E-4), and the recall rate of female donors(2.27 E-4) was higher than that of male donors(1.06 E-4). Among all donors with blood recall, 79 had a history of repeated donation, but only 3 presented multiple immunohematological abnormalities. Conclusion The recall of immunohematology defect blood was mainly due to DAT-positive, and the overall recall rate is rather low. Considering the cost-benefit ratio, it is not recommended to add additional screening procedures for DAT to all blood donors.

关 键 词：血液收回/退血 免疫血液学缺陷血液 直接抗球蛋白试验 意外抗体 

分 类 号：R457.12[医药卫生—治疗学]