住院患者红细胞血型同种不规则抗体特征分析

Specificity and clinical features of erythrocytic allo-anfibodies in hospitalized patients

目的 了解我国临床医疗机构住院患者中红细胞血型同种不规则抗体的发生特征与临床意义。方法回顾性分析2009年8月至2011年1月在复旦大学附属中山医院住院患者中检出的红细胞血型同种抗体特异性及临床特征。结果37548例住院患者中检出64例（0．17％）同种不规则抗体，其中男：女为0．6：1，有输血史：无输血史为0．9：1，2例曾发生迟发性溶血性输血反应。按抗体特异性依次为抗．E53．1％（34／64）、抗-D10．9％（7／64）、抗-cE3．1％（2／64）、抗-C1．6％（1／64）、抗-M14．1％（9／64）、抗-Mia10．9％（7／64）、抗-Lea4．7％（3／64）、抗-Dia1．6％（1／64）。Rh血型系统同种抗体多见于有输血史者（P〈0．05），Lewis血型系统同种抗体多见于男性（P〈0．05）。结论Rh血型系统抗体尤其是抗-E、抗-cE和抗-c仍然是目前我国临床最常见且最有意义的红细胞血型同种不规则抗体，也是引起迟发性溶血性输血反应的主要原因。

Objective To evaluate the occurrence and clinical significance of red blood cell （RBC） allo-antibodies among hospitalized patients in China. Methods The specificity and clinical features of RBC allo-antibodies of hospitalized patients at our hospital from August 2009 to January 2011 were retrospectively analyzed. Results Sixty-four （0. 17% ） RBC allo-antibodies were detected from 37 548 hospitalized patients. The male-to-female ratio was 0. 6：1 and the transfused： untransfused ratio 0. 9： 1. Two patients had experienced episodes of delayed hemolytic transfusion reaction （DHTR）. Their antibody frequencies were as follows ： anti-E 53, 1% （ 34/64 ）, anti-D 10. 9% （ 7/64 ）, anti-cE 3.1% （ 2/64 ）, anti-c 1.6% （ 1/64 ）, anti-M 14.1% （9/64）, anti-Mia 10. 9% （7/64）, anti-Lea 4. 7% （ 3/64 ）, anti-Dia 1.6% （ 1/64 ）. Antibodies to Rh system were more frequent among transfused patients while antibodies to Lewis system had a male predominance （both P 〈 0. 05 ）. Conclusion As the most common and clinically significant RBC alloantibodies, the antibodies to Rh blood group system, especially anti-E, anti-cE and anti-c, are the main cause of DHTR.