输血实践中意外抗体阳性分布特点及高危因素回顾性分析  

Retrospective analysis of the distribution characteristics and high risk factors of accidental antibodies in blood transfusion practice

作　　者：邓超干[1] 袁燕[1] 蔡钦泉[1] 罗钦泉 DENG Chaogan;YUAN Yan;CAI Qinquan;LUO Qinquan(Department of Blood Transfusion,Luohu District People's Hospital,Shenzhen,Guangdong 518001,China)

机构地区：[1]深圳市罗湖区人民医院输血科,广东深圳518001

出　　处：《国际检验医学杂志》2024年第S01期55-58,共4页International Journal of Laboratory Medicine

基　　金：2023年罗湖区软科学研究计划项目(LX202302018)。

摘　　要：目的分析该院近年来输血患者中出现意外抗体阳性的情况,探讨其分布特点及其临床意义。方法收集该院2018年1月至2020年12月输注红细胞患者8417例,使用抗人球蛋白微柱卡法进行意外抗体筛查和特异性鉴定,并对其数据进行分析。结果输注红细胞8417例,意外抗体阳性37例,阳性占比为0.44%(37/8417)。分析ABO血型患者产生意外抗体的情况,可见AB型血型患者的意外抗体阳性率最高;不同ABO血型患者产生意外抗体阳性率和患者住院科室比较,差异有统计学意义(P<0.05);而组间输血史、妊娠史、年龄和男女比例差异无统计学意义(P>0.05)。意外抗体特异性阳性分布分析,发现Rh血型系统抗体(计算混合抗体)占比最高,达到48.60%;其次为自身抗体13.50%,冷抗体10.80%,MNS血型系统抗体5.40%,Lewis血型系统抗体5.40%,Kidd血型系统抗5.40%,其他特异性抗体(未鉴定出特异性)10.80%。单因素分析显示,意外抗体阳性患者性别间比较差异无统计学意义(P>0.05),而年龄、ABO血型、输血史、妊娠史、不同科室之间患者意外抗体阳性比例具有显著统计学意义(P<0.05)。二元Logistic回归分析显示有输血史、妊娠史、血液系统疾病、风湿免疫肾脏疾病和重症疾病是意外抗体检出的独立危险因素(P<0.05)。结论建议对输血患者在ABO和RhD血型同型输注的基础上,至少增加RhEc和RhE同型输注,将有效降低意外抗体的产生,促进临床用血安全。Objective To analyze the occurrence of accidental antibody positivity in blood transfusion pa-tients in Luohu District People's Hospital in recent years,and to explore its distribution characteristics and clinical significance.Methods A total of 8417 patients with red blood cell transfusions in Luohu District Peo-ple's Hospital from January 2018 to December 2020 were collected and analyzed,and the data were analyzed by accidental antibody screening and specificity identification using the antiglobulin microcolumn card meth-od.Results A total of 8417 red blood cells were transfused,and 37 cases were positive for accidental antibod-ies,accounting for 0.44%(37/8417).The positive rate of accidental antibodies in ABO patients was the high-est,and the positive rate of accidental antibodies in patients with different ABO blood types and the inpatient departments of patients were statistically significant(P<0.05),while there were no significant blood transfu-sion history,pregnancy history,age and male-female ratio between groups(P>0.05).The positive distribu-tion of accidental antibody specificity showed that Rh blood group system antibody(calculated mixed antibod-y)accounted for the highest proportion(48.60%),followed by autoantibody(13.50%),cold antibody(10.80%),MNS blood group system antibody(5.40%),Lewis blood group system antibody(5.40%),Kidd blood group system antibody(5.40%),and other specific antibodies(no specificity identified)(10.80%).Un-ivariate analysis showed that there was no significant difference between the sexes of the patients with positive accidental antibodies(P>0.05),while the proportion of patients with positive accidental antibodies among different departments was statistically significant(P<0.05).Binary logistic regression analysis showed that history of blood transfusion,pregnancy,hematologic diseases,rheumatism,immunorenal diseases,and severe diseases were independent risk factors for accidental antibiotic detection(P<0.05).Conclusion It is sugges-ted that at least RhEc and RhE isotype transfu

关 键 词：意外抗体 高危因素 输血安全 

分 类 号：R457.13[医药卫生—治疗学]