286例意外抗体阳性患者鉴定结果及其输血疗效与安全性分析  

Analysis of antibody identification results and efficacy and safety of transfusion in 286 patients with positive unexpected antibodies

作　　者：罗福享 谢春梅[2] 刘峰 张雪睿[1] 兰炯采[3] LUO Fuxiang;XIE Chunmei;LIU Feng;ZHANG Xuerui;LAN Jiongcai(Department of Transfusion Medicine,Beihai People's Hospital,Beihai,536000,China;Department of Transfusion Medicine,the First Affiliated Hospital of Guangxi Medical University;Nanfang Hospital,Southern Medical University)

机构地区：[1]广西北海市人民医院输血科,广西北海536000 [2]广西医科大学第一附属医院输血科 [3]南方医科大学南方医院

出　　处：《临床血液学杂志》2024年第6期423-428,共6页Journal of Clinical Hematology

摘　　要：目的探讨广西地区意外抗体的分布,评估意外抗体阳性患者相应输血策略的疗效及安全性。方法回顾性分析2021年7月—2023年9月期间医院收治的286例意外抗体阳性患者的临床资料,将其中55例输血患者按不同的输血策略分成抗原阴性配血相合(35例)、盲配相合(11例)和盲配凝集不强于自身对照(9例)3组,收集各组患者输血前后血常规及生化资料,计算输血前后每单位红细胞血红蛋白(Hb)增量值、总胆红素及间接胆红素差值,评估各组的输血疗效及安全性。结果①286例意外抗体阳性患者的年龄分布为(44.21±23.02)岁,其中男134例,女152例(比例:0.88∶1.00);以汉族(62.8%)和壮族(32.1%)为主;以患血液系统疾病(45.1%)、肿瘤疾病(14.0%)、消化系统疾病(9.8%)、心血管系统疾病(7.0%)等为主。②共鉴定出233例特异的血型意外抗体中抗E占34.29%、抗Lea占10.45%、抗M和抗c均占8.39%,抗Mur占4.90%、抗Jka和抗C均占2.45%。③三种输血策略组的输血前后Hb增量值(χ^(2)=2.142,P=0.343)、总胆红素(χ^(2)=5.455,P=0.065)及间接胆红素(χ^(2)=2.688,P=0.261)比较,差异无统计学意义。结论广西地区以Rh、MNS、Lewis血型系统意外抗体检出为主,精准的抗体鉴定对意外抗体阳性患者实施安全输血具有重要的指导价值。Objective To explore the distribution of positive unexpected antibodies in Guangxi districts,and evaluate the efficacy and safety of the corresponding transfusion strategies for patients with positive unexpected antibodies.Methods A retrospective review of 286 cases of positive unexpected antibodies recorded in our hospital during July 2021 to September 2023 was performed.The patients were divided into three groups according to the corresponding transfusion strategy including non-reactive cross-matching test with negative antigen phenotype(35 cases),and non-reactive cross-matching test without antigen phenotype(11 cases),and positively reactive cross-matching test with the strength of agglutination no higher than those of auto-control(9 cases).Blood routine and biochemical data before and after transfusion were simultaneously collected,then the increment values of hemoglobin per unit of red blood cell and altered values of total and indirect bilirubin after transfusion were analyzed to evaluate the efficacy and safety of transfusion.Results①The age distribution of 286 patients with positive unexpected antibody was(44.21±23.02)years old,including 134 males and 152 females(ratio:0.88∶1.00);The Han nationality(62.8%)and Zhuang nationality(32.1%)were the main groups.Most patients suffered from hematologic diseases(45.1%),neoplastic diseases(14.0%),digestive diseases(9.8%),and cardiovascular diseases(7.0%).②A total of 233 blood group-specific unexpected antibodies were identified,of which anti-E(34.29%),anti-Lea(10.45%),anti-M and anti-c(8.39%),anti-Mur(4.90%),anti-Jkaand anti-C(2.45%).③The incremental value of Hb per unit of red blood cell(χ^(2)=2.142,P=0.343)and total bilirubin(χ^(2)=5.455,P=0.065)and indirect bilirubin(χ^(2)=2.716,P=0.257)had no significant difference among the three transfusion strategies groups.Conclusion Unexpected antibodies of Guangxi districts were mainly found in Rh,MNS and Lewis blood group system.Accurate antibody identification was important for guiding safe blood transfusion

关 键 词：意外抗体 抗体鉴定 输血疗效 输血安全 

分 类 号：R457.1[医药卫生—治疗学]