献血者含不规则抗体血液的处置及临床应用研究  

The processing of blood with irregular antibodies and its clinical application

作　　者：冯娜[1] 左琴琴[1] 张雅莉[1] 王锦[1] 彭鹏[1] 赵晓华[1] FENG Na;ZUO Qinqin;ZHANG Yali;WANG Jin;PENG Peng;ZHAO Xiaohua(Shaanxi Blood Center,Xi'an 710061,China)

机构地区：[1]陕西省血液中心,陕西西安710061

出　　处：《中国输血杂志》2021年第2期182-186,共5页Chinese Journal of Blood Transfusion

摘　　要：目的探讨将含不规则抗体血液制备成洗涤红细胞或者冰冻解冻去甘油红细胞(以下简称冰冻红细胞)使用的可行性,为制定献血者含不规则抗体血液处置原则、节约血液资源、减少血液浪费提供依据。方法献血者血液检出不规则抗体时,确定其类型、效价,将血浆报废,对应的悬浮红细胞按照标准化洗涤方案制备处置,观察不同效价、类型抗体血液的洗涤效果,并追踪临床应用情况。结果 2017年5月~2019年7月,本中心共筛查出45例含不规则抗体血液,经制备处置后,总体合格率为91.1%。IgM类合格率100%(25/25);IgG类合格率80.0%(16/20),其中不合格的4例均为IgG-D,效价在8~16,加洗1~2次后均符合要求。其中23例应用于临床,未发生输血反应。结论含不规则抗体的血液经制备处置后应用于临床是可行的,可大大节约血液资源;不规则抗体为IgG-D且效价较高时,应增加洗涤次数或洗涤后留样检测,无残留抗体时,方能发往临床。Objective Toexplore the viability of preparing washed RBCs ordeglycerolized RBCs(referred as frozen RBCs)from blood containing irregular antibodies, so as to provide references for formulating processing procedures of blood containing irregular antibodiestosave blood resources and reduce blood wastage. Methods Once irregular antibodies were yielded,their type and titerwere determined.The plasma was discarded, and the suspended RBCs were prepared and processed according to the standardized washing scheme.The processing effect of blood with different titers and types of antibodies was observed, and theirfurther clinical application was followed up.Results From May 2017 to July 2019, a total of 45 blood samples containing irregular antibodies were screened in our center. The overall qualified rate reached 91.1% after processing. 100%(25/25) was qualified in IgM,and 80.0%(16/20)in IgG.4 samples,initially noncom for mingdue to IgG-Dwith titerranged8~16,met the requirements after one or two additional washing processes. Among them, 23 cases were issued and appliedin clinicaland noadeverse reactions to blood transfusionoccurred.Conclusion After appropriate processing, blood containing irregular antibody can be applied to the clinical to save blood resources. When the irregular antibody is IgG-D and the titer is high, the washing times should be increased,and only when there is no residual antibodycan the samples be issued to the clinical.

关 键 词：献血者 不规则抗体 血液 处置 应用 合格率 

分 类 号：R457.11[医药卫生—治疗学]