建立红细胞同种抗体检测数据库的临床意义  

Clinical significance of establishing a red blood cell alloantibody detection database

作　　者：肖潇 陈龙 赵珍玉 何璋函 周梦君 唐洁 XIAO Xiao;CHEN Long;ZHAO Zhenyu;HE Zhanghan;ZHOU Mengjun;TANG Jie(Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院绵阳市中心医院,四川绵阳621000

出　　处：《中国输血杂志》2025年第1期54-60,共7页Chinese Journal of Blood Transfusion

摘　　要：目的探讨建立红细胞同种抗体检测数据库的临床意义及应用价值。方法选择2020年1月1日至2024年5月1日本院拟输血的患者为研究对象,应用Microsoft Office Excel软件建立红细胞同种抗体检测数据库,登记患者同种抗体和不明抗体的检测数据,并对数据库中患者的临床特征、抗体分布以及抗体衰减与复阳情况进行回顾分析。抗体筛查和抗体鉴定常规使用LISS-IAT法。结果在同种抗体中,Rh血型系统抗体检出率最高,其次为MNS血型系统抗体和Lewis血型系统抗体。Rh血型系统抗体以抗-E为主。单因素分析中,抗体是否阳性与患者的性别、年龄、输血史、妊娠史以及疾病类型相关,差异具有统计学意义(P均<0.001)。在数据库中,有48例发生抗体衰减,占15.24%(48/315),抗体衰减平均时间跨度为22~1324 d,抗体衰减后复阳的有6例,抗体复阳均与输血有关,致抗体复阳的输血时间间隔最短为3 d,最长为427 d;58例不明抗体中有3例转化为同种抗体:2例为抗-E,1例为抗-Le^(a)。结论建立红细胞同种抗体检测数据库是指导临床疑难交叉配血的有效方式,也是输血风险管控的有效措施。Objective To explore the clinical significance and application value of establishing a database for red blood cell alloantibody detection.Methods Patients who were scheduled for blood transfusion in our hospital from January 1,2020 to May 1,2024 were selected as the research subjects.A red blood cell alloantibody detection database was established using Microsoft Office Excel software to register the detection data of patients′alloantibodies and antibodies of undetermined specificity(AUS).A retrospective analysis was conducted on the clinical characteristics,antibody distribution,antibody decay and repeat positivity of the patients in the database.The LISS-IAT method was routinely used for antibody screening and identification.Results Among the alloantibodies,the Rh blood group system had the highest detection rate,followed by antibodies of the MNS blood group system and the Lewis blood group system.The predominant antibody in the Rh blood group system was anti-E.In the univariate analysis,the positivity of antibody was significantly associated with the patient′s gender,age,blood transfusion history,pregnancy history and type of disease(all P<0.001).In the database,48 patients experienced antibody decay,accounting for 15.24%(48/315),with an average time span of antibody decay ranging from 22 to 1324 days.Six cases showed repeat positivity after decay,which were related to blood transfusions.The shortest interval between blood transfusions that led to antibody repeat positivity was 3 days,and the longest interval was 427 days.Among 58 cases with AUS,3 converted into alloantibodies,among which 2 were anti-E and 1 was anti-Lea.Conclusion Establishing a red blood cell alloantibody detection database is an effective way to guide ambiguous cross-matching in clinical practice and is also an effective measure for the management of transfusion risks.

关 键 词：抗体筛查 同种抗体 抗体衰减 不明抗体 

分 类 号：R457.1[医药卫生—治疗学]