多重不规则抗体致β地中海贫血孕妇红细胞输注无效并文献复习  

Ineffective erythrocyte transfusion in pregnant women with β-thalassemia induced by multiple irregular antibodies and literature review

作　　者：杨丽艳 凤婧[1] 沈瑶 郭彬瀚 叶萍 陈剑[1] Yang Liyan;Feng Jing;Shen Yao;Guo Binhan;Ye Ping;Chen Jian(Department of Laboratory Medicine,Key Laboratory of Birth Defects and Related Diseases of Women and Children(Sichuan University),Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川大学华西第二医院检验科、出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《国际输血及血液学杂志》2022年第2期153-157,共5页International Journal of Blood Transfusion and Hematology

摘　　要：目的探讨β地中海贫血孕妇红细胞输注无效的原因,并进行相关文献分析。方法选择2017年7月5日,四川大学华西第二医院收治的1例外院红细胞输注无效的β地中海贫血孕妇为研究对象。本例患者为27岁,G1P0,孕30^(+1)周,因"孕期β地中海贫血加重、外院2次红细胞输注无效"入本院。对本例孕妇及其新生儿的血型血清学检查结果及输血相关病例资料进行回顾性分析。以"红细胞输注无效""不规则抗体""意外抗体""erythrocyte transfusion""ineffective""irregular antibodies""unexpected antibodies"为中、英文关键词,分别对万方数据知识服务平台和PubMed数据库建库至2020年6月30日收录的不规则抗体致红细胞输注无效相关文献进行检索,并且对纳入文献进行文献复习,总结患者不规则抗体检出情况及输血相关临床特征。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求,并且与本例患者签署临床研究知情同意书。结果①孕妇血型为AB、DCCee、JK(a-b+)型,其血浆标本中检出E、c和JK^(a)抗体。②本例孕妇于本院接受AB、DCCee、JK(a-b+)型红细胞3 U输注后,血红蛋白(Hb)值由69 g/L上升至84 g/L,提示红细胞输注有效。该孕妇的新生儿血型为B、DCCee、JK(a-b+)型,未发生新生儿溶血病,经观察后出院。③根据文献检索策略,共纳入4篇相关文献,报道5例不规则抗体致红细胞输注无效患者,文献复习结果显示,对于不规则抗体筛查结果呈阳性的患者,在明确抗体性质后,选择相应抗原阴性的供者红细胞输注,安全有效。结论对于不规则抗体筛查呈阳性的患者,特别是需多次输血者,为确保其输血安全和有效,应于输血前进行不规则抗体鉴定,并且选择相应抗原阴性的供者红细胞输注。Objective To analyze cause of ineffective erythrocyte transfusion in a pregnant woman withβ-thalassemia,and to review related literature.Methods On July 5,2017,a pregnant woman withβ-thalassemia who had ineffective erythrocyte transfusion in another hospital and then admitted to West China Second University Hospital,Sichuan University,was selected as the research subject.This pregnant woman was 27 years old,G1P0,30^(+1 )weeks of pregnancy,and admitted to our hospital because of"aggravation ofβ-thalassemia during pregnancy and ineffectiveness of twice erythrocyte transfusions in other hospitals".Blood group serological test results and blood transfusion-related clinical data of this pregnant woman and her newborn were analyzed retrospectively.With the key words of"erythrocyte transfusion""ineffective""irregular antibodies""unexpected antibodies"both in Chinese and English,literature related to ineffective erythrocyte transfusion caused by blood group antibodies were searched from Wanfang data knowledge service platform and PubMed database.Literature retrieval time was set from construction of above databases to June 30,2020.Detection results of blood group antibodies and clinical characteristics of blood transfusion of patients in related literature were summarized.This study was in line with World Medical Association Declaration of Helsinki revised in 2013 and informed contents were obtained from this patient.Results①The pregnant woman′s blood type was AB,DCCee and JK(a-b+).And anti-E,anti-c and anti-JKa were detected in her plasma.②In our hospital,the pregnant woman was infused with 3 U erythrocytes with AB,DCCee,JK(a-b+)blood group,then her hemoglobin(Hb)value increased from 69 to 84 g/L,which suggested erythrocyte transfusion was effective.Her newborn′s blood type was B,DCCee,JK(a-b+),and she had not develop hemolytic disease of newborn.After observation,this new born was discharged.③According to the literature search strategy,a total of 4 related literature were included,which reported 5 patients

关 键 词：Β地中海贫血 红细胞输注 输血 输注无效 不规则抗体 意外抗体 

分 类 号：R714.254[医药卫生—妇产科学] R446.6[医药卫生—临床医学]