大样本住院患者血型意外抗体检测结果的危险因素分析  

Risk factors analysis of blood type unexpected antibody in large sample of inpatients

作　　者：顾小文[1] 王玥[1] 尤建国[1] GU Xiaowen;WANG Yue;YOU Jianguo(Department of Blood Transfusion,Huaian First People′s Hospital,Huaian 223300,China)

机构地区：[1]淮安市第一人民医院输血科,江苏淮安223300

出　　处：《中国输血杂志》2023年第8期701-705,共5页Chinese Journal of Blood Transfusion

基　　金：江苏省输血协会英科新创科研基金(JS2022029)。

摘　　要：目的观察分析住院患者血型意外抗体检测结果及其产生的危险因素,为推动临床安全输血提供参考。方法采用回顾性分析法,收集22800名住院患者临床资料,分别采用微柱凝胶法和盐水介质法完成意外抗体筛查,根据筛查结果分为阳性组(62例)和阴性组(22738例)。收集2组患者临床资料并进行单因素分析,其中阳性组进行意外抗体特异性鉴定,并统计抗体特异性分布特点,采用二元Logistic回归分析意外抗体阳性的危险因素。结果22800名住院患者中,意外抗体阳性检出率为0.27%(62/22800)。62名患者中,Rh血型系统抗体占40.32%(25/62),MNS血型系统抗体占14.52%(9/62)、Lewis血型系统抗体占比6.45%(4/62)、Kidd血型系统抗体占1.61%(1/62)、混合抗体占比20.97%(13/62)、自身抗体占比6.45%(4/62)、其他占比9.68%(6/62)。单因素分析结果显示,阳性组患者性别、年龄、妊娠史、输血史、输血次数、疾病类型与意外抗体阴性组患者比较,经卡方检验存在显著差异(χ^(2)=11.142、6.994、12.453、4.762、5.493、92.381,P均<0.05),2组患者在民族之间,无显著性差异(χ^(2)=3.719,P>0.05)。二元Logistic回归分析显示,女性、年龄>60岁、有输血史、输血次数>3次、有妊娠史、实体肿瘤和血液系统疾病、内科重症疾病是意外抗体阳性独立危险因素(P均<0.05)。结论针对有输血要求的患者,尤其是具备上述危险因素的,建议输血前进行意外抗体的筛查与鉴定,规避相应抗体,选择相应抗原阴性的血液进行交叉配血,以保证临床输血有效性和安全性。Objective To observe and analyze the detection results of blood type unexpected antibody and its risk factors in inpatients,so as to provide reference for promoting the safety of clinical blood transfusion.Methods Clinical data of 22800 inpatients were collected retrospectively and unexpected antibody screening was performed by microcolumn gel method and saline method.According to the screening results,the inpatients were divided into positive group(n=62)and negative group(n=22738).Clinical data of the two groups were collected and analized by univariate analysis,and specificity identification of unexpected antibody was performed in the positive group.The specific distribution characteristics of antibody were statistically analyzed,and the risk factors of unexpected antibody were analyzed by binary logistic regression.Results Among the 22800 inpatients,the yield rate of unexpected antibody was 0.27%(62/22800),with Rh,MNS,Lewis,Kidd blood group antibody,mixed antibody,autoantibodies and others accounted for 40.32%(25/62),14.52%(9/62),6.45%(4/62),1.61%(1/62),20.97%(13/62),6.45%(4/62)and 9.68%(6/62),respectively.Univariate analysis showed that there were significant differences in gender,age,pregnancy history,blood transfusion history,blood transfusion frequency and disease type between the positive group and the negative group by chi-square test(χ^(2)=11.142,6.994,12.453,4.762,5.493,92.381,all P<0.05),while there was no significant difference in nationality(χ^(2)=3.719,P>0.05).Binary logistic regression analysis showed that female,age>60 years old,with history of blood transfusion,number of blood transfusion>3 times,history of pregnancy,solid tumor and blood diseases,severe internal medical diseases were independent risk factors for unexpected antibody(P<0.05).Conclusion For patients who need blood transfusion,especially those with the above risk factors,conducting unexpected antibodies screening and identification before transfusion,avoiding corresponding antibodies and selecting antigen-negative blood for cross

关 键 词：意外抗体 筛查 危险因素 输血安全 住院患者 血型 

分 类 号：R457.1[医药卫生—治疗学]