输血前不规则抗体筛查结果分析

Analysis of screening results of irregular antibodies before blood transfusion

目的输血前对患者血清(浆)进行不规则抗体筛选和鉴定,分析不规则抗体的分布特征,预防溶血性输血反应的发生。方法用微柱凝胶法对2006年6月到2007年12月间临床送检的疑难配血标本进行不规则抗体筛选和鉴定,分析不规则抗体的类型和分布特征。结果不规则抗体筛选鉴定阳性54例,其中同种抗体26(51.85%)例,自身抗体26(48.15%)例,抗体特异性未确定2例,同种抗体中以Rh系统最多,占15/28(53.57%),其次为MNSs系统,占5/26(19.23%),Rh系统抗-E明显多于抗-D,与以往文献报道不同;MNSs系统主要是抗-M;自身抗体主要为抗IgG型抗体占14/26(53.84%),其次为抗IgG和抗C3d抗体同时阳性占8/26(30.77%),冷自身抗体最少占4/26(15.38%);对有同种抗体的患者输入相应抗原阴性的红细胞后,患者未发生溶血性输血反应;有自身抗体的患者按自身溶血性贫血的输血原则进行输血后患者贫血症状缓解。结论输血前进行不规则抗体筛查,选择合适的血液输注能有效地降低或避免溶血性输血反应的发生,保证临床输血的安全性。

Objective To identify serum or plasma irregular antibodies in patients, analyze their distribution characteristic, so as to prevent hemolytic transfusion reaction. Methods Microcolumn gel immunoassay was applied to screening and identifying irregular antibodies in clinical suspicious matching blood samples from June 2006 to December 2007, and then the types and distribution characteristic of irregular antibodies were analyzed. Results 54 cases were irregular antibody positive, in which 28 cases （51.85%） were homologous antibodies, 26 cases （48. 15%） were autologous antibodies, 2 cases were unidentified antibodies. In homologous antibodies, Rh system antibody was predominant （53.57%） （in which anti E was more than anti D）, followed by MNSs system antibody （19.23%）. Anti M （5, 9.26%） was the most in MNSs system. In autologous antibodies, anti IgG was the most （53.84%）, followed by anti-IgG＋anti C3d （30.77%） and cold autoantibody （15.38%）. No hemo lyric transfusion reaction occurred in patients with isoantibody after infusion of blood with correspond ing antigen negative. The symptom of anaemia was alleviated in patients with autoantibody after quantitative washed red cells infusion. Conclusion Screening of irregular antibodies and infusion of suitable blood are conductive to decrease or avoidance of hemolytic transfusion reaction, and guarantee of blood safety.