广州地区无偿献血者不规则抗体筛查结果分析

Investigation of irregular antibodies of red blood cell in Guangzhou blood donors

目的了解广州地区无偿献血者不规则抗体的频率、类型、特异性和抗体效价,为输血前检查策略的制定提供依据。方法随机抽取2012年11月至2013年3月广州血液中心无偿献血者血液样本20 160例,选择含特定抗原的筛选红细胞,采用聚凝胺介质微板法进行不规则抗体初筛,阳性样本使用试剂筛选细胞和试管法进行确证试验,仍然阳性的样本采用谱细胞微柱法进行特异性鉴定并测定效价。结果 20 160名广州地区无偿献血者中共筛查出不规则抗体97例,检出率为0.48%,其中IgG型抗-E 1例,IgM型抗体96例,包括抗-P1 4例,抗-M 2例,抗-Lewisa+b1例,上述抗体效价均不超过8;冷自身抗体59例和非特异性不规则抗体30例。女性不规则抗体阳性率显著高于男性(χ2=18.720 1,P=1.51E-05)。结论广州献血人群中存在低比例的不规则抗体,对献血者进行不规则抗体筛查有利于电子配血及血液预警系统的建立,对提升临床用血安全性、有效性和智能化水平有着重要意义。

Objective To investigate the irregular antibodies of red blood cell among blood donors in Guangzhou area, including frequency, specificity, type and titer, and provide the scientific data for screening strategy of pre-transfusion test. Methods 20 160 blood samples of donors were randomly collected from November 2012 to March 2013 in Guangzhou Blood Center. Irregular antibodies screening test was performed by mircoplate method in polybrene medium. Positive samples were verified by screening cells with tube method. Specificity of the irregular antibodies was identified by panel cells and the titer was determined with microcolumn gel method. Results Among 20 160 blood donors, 97 cases（0.48%） were positive for irregular antibodies screening, including 1 case of anti-E （IgG）, 4 cases of anti-P 1 （IgM）, 2 cases of anti-M （IgM） and 1 case of anti-Lewis^a＋b （IgM）, with titer no higher than 8. The remains were 59 cold auto-antibodies and 30 nonspecific irregular antibodies. The positive rate of irregular antibodies was higher in female than in male donors （X2= 18.720 1, P= 1.51E-05）. Conclusion Low prevalence of irregular antibodies was found among blood donors in Guangzhou area. The screening of irregular antibodies is useful for establishing the electronic cross matching technology and baemovigilance system. It might be significant to improve the safety, effectiveness and intelligent level for clinical blood transfusion.