临床输血前不规则抗体筛查和鉴定的意义

Significance of the Irregular Antibody Screening and Identification before Clinical Transfusion

目的探讨临床输血前进行不规则抗体筛查和鉴定的意义。方法选择自2010年1月至2011年6月，于厦门大学附属第一医院接受输血前不规则抗体筛查的8876例患者为研究对象。采用微柱凝胶法对患者血液样本进行抗体筛选，对筛选出不规则抗体阳性的患者进行抗体特异性鉴定。统计学分析比较不规则抗体筛查结果（本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该伦理会批准，分组征得受试对象本人的知情同意，并与之签订临床研究知情同意书）。结果不规则抗体呈阳性的患者为73例（73／8876，0．82％），其中女性所占比例高于男性（χ^2=13．01，P〈0．005）；验出特异性抗体的患者为49例（49／73，67．12％），未确定特异性抗体患者为8例（8／73，10．96％）；验出自身抗体患者为16例（16／73，21．92％），16例自身抗体患者中，有2例同时还存在抗-E同种抗体；验出抗-JKa抗体引起的新生儿溶血病1例。经交叉配血输血后，所有患者均未发生溶血性输血反应。结论输血前进行不规则抗体的筛查和鉴定，可以防止不规则抗体引起的溶血性输血反应发生，保证临床输血安全。同时为新生儿溶血病的诊断和治疗提供了重要的参考依据，对于抗体筛查阳性的择期手术患者选择足够配合性血液创造了时间。

Objective To investigate the significance of the irregular antibody screening and identification before the blood transfusion. Methods From January 2010 to June 2011,8876 patients were screened for irregular antibody by Micro-column gel agglutination assay and then the antibody type of those irregular antibodies was identified. （The study protocol was approved by the Ethical Review Board of Investigation in Human Being of The First Affiliated Hospital of Xiamen University）. Results Among all of these screened patients, 73 patients carried irregular antibody （0.82 %）. Quantity of female patients with irregular antibodies was much higher than that of male（χ^2 = 13.01, P〈0.05）. Forty nine patients, sixteen patients and eight patients were proved that carrying specific antibodies, auto-antibodies and undetermined- specific antibodies, separately. There were two patients carried anti-E isoantibody among those 16 patients with anto-antibodies. And hemolytic transfusion reactions were not detected in those 73 patients receipt blood transfusion after cross-matching. Conclusions Irregular antibody screening and identification before blood transfusion could prevent hemolytic transfusion reactions causing by irregular antibodies, and ensure clinical safety of blood transfusion.