常州地区疑难输血患者不规则抗体的特异性分析  

Specificity analysis of irregular antibody in patients with difficult blood transfusion in Changzhou area

作　　者：闵志军[1,2] 张建伟 曹锁春[1] 徐立[1] 许飞[1,2] MIN Zhijun;ZHANG Jianwei;CAO Suochun;XU Li;XU Fei(Changzhou Blood Center,Changzhou,213004,China;Changzhou Key Specialty Laboratory of Clinical Blood Transfusion)

机构地区：[1]常州市中心血站,江苏常州213004 [2]常州市临床输血重点专科实验室

出　　处：《临床血液学杂志》2024年第6期432-436,共5页Journal of Clinical Hematology

摘　　要：目的分析常州地区疑难输血患者不规则抗体的检出情况。方法对常州地区2019-2023年各医院送检的疑难配血患者标本,应用盐水法、聚凝胺法、抗球蛋白法[微柱凝集法和(或)试管法]检测不规则抗体。结果共确认血型不规则抗体539例。其中同种特异性抗体436例(80.89%),分别为:Rh 279例(51.76%),MNS 64例(11.87%),Lewis 31例(5.75%),Kidd 7例(1.30%),Duffy 3例(0.56%),P 6例(1.11%),Diego 3例(0.56%),Luther 1例(0.19%),Xg 1例(0.19%),混合抗体33例(6.12%),类同种自身抗体8例(1.48%);其他抗体103例(19.11%),分别为:自身抗体35例(6.49%),冷抗体16例(2.97%),药物抗体6例(1.11%),抗-CD38抗体32例(5.94%),未知特异性抗体14例(2.60%)。结论检出的不规则抗体与笔者先前报道有较大差异,但Rh血型系统抗体仍然是临床疑难输血患者中最常见的不规则抗体,建议临床尽早实行Rh系统同型输注,以减少Rh系统抗体的产生,提高地区输血安全水平。Objective The detection of irregular antibody in patients with difficult blood transfusion in Changzhou area was analyzed.Methods Saline method,polycoagulant method and antiglobulin method(microcolumn agglutination method and/or test tube method)were used to detect irregular antibodies in samples of patients with difficult blood matching sent to hospitals in Changzhou area from 2019 to 2023.Results A total of 539 cases of irregular blood group antibody were identified.There were 436 cases(80.89%)of homospecific antibodies,which were:Rh 279 cases(51.76%),MNS 64 cases(11.87%),Lewis 31 cases(5.75%),Kidd 7 cases(1.30%),Duffy 3 cases(0.56%)and P 6 cases(1.11%).There were 3 cases of Diego(0.56%),1 case of Luthera(0.19%),1 case of Xg(0.19%),33 cases of mixed antibody(6.12%),and 8 cases of autoantibody(1.48%).There were 103 other antibodies(19.11%),including:autoantibody 35 cases(6.49%),cold antibody 16 cases(2.97%),drug antibody 6 cases(1.11%),anti-CD38 antibody 32 cases(5.94%)and unknown specific antibody 14 cases(2.60%).Conclusion The irregular antibodies detected were significantly different from those previously reported by the author,but Rh blood group system antibodies were still the most common irregular antibodies in patients with difficult clinical transfusion.It is recommended to implement Rh system isotype transfusion as early as possible to reduce the production of Rh system antibodies and improve the regional blood transfusion safety level.

关 键 词：血型 不规则抗体 频率 输血安全 

分 类 号：R457.1[医药卫生—治疗学]