2023年全国临床输血相容性检测室间质量评价结果分析  

Analysis on the results of national external quality assessment for transfusion compatibility test in 2023

作　　者：胡俊华[1] 张芃[1] 刘燕明[1] 田胜辰 马婉茹 李祥 赵学彬 薛峰 王云田 林东[1] 孙峥[1] 周琳[2] 宫济武[1] Hu Junhua;Zhang Peng;Liu Yanming;Tian Shengchen;Ma Wanru;Li Xiang;Zhao Xuebin;Xue Feng;Wang Yuntian;Lin Dong;Sun Zheng;Zhou Lin;Gong Jiwu(Department of Blood Transfusion,Beijing Hospital,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,National Center of Gerontology,Beijing 100730,China;Beijing Hospital,National Center for Clinical Laboratories,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,National Center of Gerontology,Beijing 100730,China)

机构地区：[1]北京医院输血科、国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [2]北京医院、国家老年医学中心、国家卫生健康委临床检验中心、中国医学科学院老年医学研究院,北京100730

出　　处：《中华检验医学杂志》2025年第2期223-229,共7页Chinese Journal of Laboratory Medicine

摘　　要：目的分析2023年全国临床输血相容性检测室间质量评价(EQA)开展情况,为临床输血相容性检测质量管理提供参考。方法国家卫生健康委临床检验中心(NCCL)2023年向全国31个省(自治区、直辖市)4186家参评实验室(包括2961家三级医院实验室、1085家二级医院实验室、23家一级医院实验室、106家血站实验室和11家第三方医学检验实验室)共发放3次、每次22份EQA标本(包括1.5 ml/支的红细胞及血浆样本各11份),进行ABO正定型、ABO反定型、RhD血型、抗体筛检、交叉配血5项临床输血相容性检测,并收集回报结果数据。将上报结果数据按照地区分布、实验室分级、检测方法学、试剂及检测系统使用等方面进行统计分析并评价。结果2023年全国临床输血相容性检测中,ABO正定型、ABO反定型、RhD血型、抗体筛检、交叉配血项目的EQA合格率分别为96.68%(4047/4186)、95.10%(3981/4186)、96.46%(4038/4186)、95.32%(3990/4186)和91.04%(3811/4186);三级医院实验室EQA合格率为87.77%(2599/2961),高于二级医院实验室的77.79%(844/1085)(P<0.05);不同地区的EQA合格率以及三级医院、二级医院参评实验室合格率差异有统计学意义(P均<0.05);微柱凝集法在ABO正定型、ABO反定型、RhD血型、抗体筛检、交叉配血项目中的使用率分别为80.81%(10080/12474)、75.06%(9337/12440)、81.38%(10118/12433)、89.59%(11104/12394)和76.25%(9495/12453);在ABO正定型检测项目中,微柱凝集法的合格率高于盐水玻片法(P<0.05);在抗体筛检项目中,微柱凝集法合格率高于聚凝胺法和抗人球试管法(P均<0.05);在ABO反定型、抗体筛检和交叉配血3个项目中7种试剂的合格率差异均有统计学意义(P均<0.05);除ABO反定型项目中试剂1单一体系的合格率高于混合体系(P<0.05),其他试剂的2种检测体系间的合格率比较,差异无统计学意义(P>0.05)。结论不同地区和不同等级实验室的检测能力存在差异,微柱�Objective To analyze the results of national external quality assessment(EQA)for transfusion compatibility test in 2023,and provide reference for quality management of clinical transfusion compatibility testing.MethodsThe EQA of clinical transfusion compatibility testing by NCCL was performed 3 times in 2023 among included laboratories.The panel consisting of 22 samples was distributed to 4186 laboratories across 31 provinces(Including 2961 tertiary hospital laboratories,1085 secondary hospital laboratories,23 primary hospital laboratories,106 blood station laboratories and 11 independent clinical laboratories).Each panel contains 11 red blood cell and 11 plasma samples per 1.5 ml/tube.Each participant laboratory of the EQA program was required to carry out the detection and return results in expected time.Statistical analysis and evaluation on the reported results were conducted by NCCL from the aspects of regional distribution,laboratory grading,testing methodology,reagent and testing system usage.ResultsThe qualification rates of EQA for five items including ABO positive typing,ABO reverse typing,RhD blood type,antibody screening,and cross matching were 96.68%,95.10%,96.46%,95.32%,and 91.04%,respectively.The EQA qualification rate of tertiary hospital laboratories was 87.77%(2599/2961),which was significantly higher than the 77.79%(844/1085)of secondary hospital laboratories.There were significant differences in the qualification rate of participating laboratories among different regions.The utilization rates of micro column agglutination method in ABO positive typing,ABO reverse typing,RhD blood type,antibody screening,and cross matching were 80.81%(10080/12474),75.06%(9337/12440),81.38%(10118/12433),89.59%(11104/12394)and 76.25%(9495/12453),respectively.The qualification rate of micro column agglutination method was significantly higher than that of saline slide method in ABO positive typing detection(P<0.05).The qualification rate of micro column agglutination method was significantly higher than that of th

关 键 词：输血 临床实验室 室间质评 质量控制 

分 类 号：R457.1[医药卫生—治疗学]