中国献血人群意外抗体阳性率的Meta分析  

Meta-analysis:Unexpected Antibody Positive Rate of Blood Donors in China

作　　者：郭伟洁[1] 刘泽雅 张凡 赫喜荣 常玥 陈利达[1] 王文静[1] 芦宏凯[1] GUO Wei-jie;LIU Ze-ya;ZHANG Fan(Blood Transfusion Department of China-Japan Friendship Hospital,Beijing 100029)

机构地区：[1]北京中日友好医院,100029

出　　处：《临床输血与检验》2021年第2期202-212,共11页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的通过Meta分析估算中国献血人群意外抗体的阳性率,分析我国献血人群红细胞意外抗体的分布特点,为判断我国献血人群是否需要进行意外抗体检测实验提供数据基础。方法在PubMed、CNKI、WanFang Data、VIP和CBM数据库中,通过输入特定的检索词检索有关我国献血人群意外抗体的相关文献,检索时间为建库时~2019年12月。由五位研究人员按照纳入排除标准独立进行文献筛选、提取相关资料并进行方法学质量评价,使用R3.6.2软件进行Meta分析。结果共纳入38个横断面研究,Meta分析结果显示:我国献血者的总抗体阳性率为0.20%[95%CI(0.15%,0.25%)];男性献血者抗体阳性率为0.13%[95%CI(0.10%,0.16%)],女性献血者抗体阳性率为0.31%[95%CI(0.26%,0.37%)],女性献血者抗体阳性率高于男性抗体阳性率,差异存在统计学意义;其中抗体类型多以IgM型为主,占抗体阳性总数的59.78%[95%CI(50.01%,69.54%)],IgG型抗体占抗体阳性总数的31.33%[95%CI(23.44%,39.22%)],且IgG型抗体多见于女性;根据抗体鉴定结果发现,各血型系统抗体阳性率不同,Rh系统约占31.64%[95%CI(25.25%,38.03%)](约99.61%为IgG型抗体,以抗-D、抗-E为主),MNS系统约占23.73%[95%CI(18.80%,28.65%)](约88.74%为IgG型抗体,以抗-M为主),Lewis系统约占8.18%[95%CI(5.71%,10.66%)](主要为IgG型抗体,以抗-Lea为主),P系统约占4.54%[95%CI(2.58%,6.51%)](主要为IgM型抗体,以抗-P为主),其他类(包括非特异性抗体、自身抗体)占22.78%[95%CI(14.09%,31,46%)](主要为IgM型抗体),Kell系统约占0.05%[95%(0,0.46%)],Duffy系统约占0.05%[95%CI(0,0.46%)](主要为IgG型抗体,以抗-Fya为主),Kidd系统约占0.01%[95%CI(0,0.42%)](均为抗-Jka),Diego系统约占0.01%[95%CI(0,0.4%)](均为抗-Dia);抗体频率排序:抗-M>抗-D>抗-E>抗-Lea>抗-P>抗-Leb>抗-N>抗-cE>抗-C>抗-Fya>抗-Jka>抗-Dia。结论将意外抗体筛查实验纳入献血者常规检测项目存在一定必要性,针对献血者常见意外抗体开发�Objective Meta-analysis was performed to analysis positive rate and distribution characteristics of unexpected antibodies in Chinese blood donors to provide data for judging whether blood donors in China needs to carry out unexpected antibodies detection.Methods We searched PubMed,CNKI,WanFang Data,VIP,and CBM databases and entered specific search terms for relevant literature on unexpected antibodies in Chinese donors from inception to December 2019.According to inclusion and exclusion criteria,five researchers independently screened literature,extracted relevant data and assessed the methodological quality.The R3.6.2 software was used to perform meta-analysis.Results A total of 38 cross-sectional studies were included.Meta-analysis results showed that total antibody positive rate of donors in China was 0.20%[95%CI(0.15%,0.25%)].The antibody positive rate of male donors was 0.13%[95%CI(0.10%,0.16%)],and that of female donors was 0.31%[95%CI(0.26%,0.37%)].The antibody positive rate of female donors was higher than that of male donors.There was no statistically significant difference.Among the positive antibodies,the most abundant antibody isotype was IgM,accounting for 59.78%[95%CI(50.01%,69.54%)].IgG antibody accounted for 31.33%[95%CI(23.44%,39.22%)]of the total positive antibodies and IgG antibodies were more common in females.Based on the results of antibody identification,the positive rate of antibody in each blood group system was different:Rh system accounting for about 31.64%[95%CI(25.25%,38.03%)](about 99.61%were IgG antibodies,mainly anti-D and anti-E),MNS system accounting for about 23.73%[95%CI(18.80%,28.65%)](about 88.74%were IgG antibodies,mainly anti-M),Lewis system accounting for about 8.18%[95%CI(5.71%,10.66%)](mainly IgG antibodies,mainly anti-Lea),P system accounting for about 4.54%[95%CI(2.58%,6.51%)](mainly IgM antibody,mainly anti-P),other systems(including non-specific antibody and autoantibody)accounting for 22.78%[95%CI(14.09%,31,46%)](mainly IgM antibody),Kell system accounting for about

关 键 词：中国 献血者 意外抗体 META分析 

分 类 号：R457.1[医药卫生—治疗学]