132例疑难交叉配血原因分析

Analysis of the Causes of 132 Cases of Difficult Cross-matching Blood

目的:探讨132例疑难交叉配血原因及常见不规则抗体分布情况。方法:回顾性分析2019年1-12月笔者所在医院收治的132例疑难交叉配血患者的临床资料,分析132例疑难交叉配血的原因及常见不规则抗体分布情况。结果:(1)疑难配血原因中,同种抗体占比最高为50.76%,其次为自身温抗体(27.27%)、未知特异性不规则抗体(9.85%),血浆蛋白干扰的因素最低,占0.76%。(2)不规则抗体具体分布情况显示,抗-M不规则抗体占34.43%,其次为抗-E不规则抗体,占24.59%,抗-cE不规则抗体占20.49%。另有13例患者血清与谱细胞有反应,但无法确认抗体特异性。抗-M不规则抗体患者中97.62%(41/42)有既往免疫史,抗-E不规则抗体患者中76.67%(23/30)有既往免疫史。结论:引起临床疑难交叉配血的原因主要是同种抗体和自身温抗体,为避免上述情况出现,为患者制定合适的输血方案前首要进行抗体筛查。

Objective:To investigate the causes of difficult cross-matching blood and the distribution of common irregular antibodies of 132 cases.Method:The clinical data of 132 patients with difficult cross-matching blood admitted in our hospital from January to December 2019 were retrospectively analyzed.The causes of difficult cross-matching blood and the distribution of irregular antibodies in 132 cases were analyzed.Result:(1) Among the causes of cross-matching blood,the proportion of the same antibody was the highest 50.76%,followed by auto-temperature antibody (27.27%),unknown specific irregular antibody (9.85%),and the interference factor of plasma protein was the lowest,accounting for 0.76%.(2) The specific distribution of irregular antibodies showed that anti-M irregular antibodies accounted for 34.43%,followed by anti-E irregular antibodies,accounting for 24.59%,and anti-cE irregular antibodies accounting for 20.49%.Another 13 patients’ sera reacted with profile cells,but the antibody specificity could not be confirmed.97.62% (41/42) of patients with irregular anti-M antibody had a previous history of immunization,and 76.67% (23/30) of patients with irregular anti-E antibody had a previous history of immunization.Conclusion:The main cause of clinically difficult cross-matching blood are same antibody and auto-temperature antibody.In order to avoid the occurrence of the above situation,antibody screening should be carried out before the formulation of appropriate blood transfusion program for the patient.