广西地区部分患者抗-Mur漏检及其导致溶血性输血反应的研究

The study of missing detection of anti-Mur and anti-Mur induced hemolytic transfusion reaction in the patients of Guangxi

目的调查广西部分患者抗-Mur漏检频率及其导致的溶血性输血反应的特点,为指导本地区的安全输血提供依据。方法回顾性调查2016-2017年本院申请输血患者的病历,收集抗筛阳性患者和其他输血相容性试验中意外发现的抗-Mur患者的实验室数据及临床资料等进行统计分析。结果 31 966例患者病历中,抗筛阳性共224例(0. 70%),抗筛阴性而意外发现的抗-Mur 16例(0. 05%),这些患者均有孕产史和/或输血史,其中2人发生溶血性输血反应。结论广西部分患者抗-Mur漏检频率较高,该抗体的产生与患者多次妊娠和/或输血免疫刺激密切相关,可导致部分患者发生溶血性输血反应。为避免抗-Mur的漏检,保障安全输血,建议本地区抗体筛选细胞中增加GP. Mur表型红细胞。

Objective To investigate the prevalence of the missing detection of anti-Mur and the characteristic of antiMur induced hemolytic transfusion reaction in some patients of Guangxi. We aim to provide valuable reference data to improve the safety of blood transfusion in the region. Methods Erythrocyte request records of patients in our hospital were retrospectively reviewed from 2016 to 2017. Laboratory and Clinical data of these patients with antibodies detected by antibody screening tests,and patients with anti-Mur which were found accidentally from other pre-transfusion tests,were collected for statistical analysis. Results In total,31 966 patients were enrolled in this study. Among them,224( 0. 70%) patients with antibodies were detected by antibody screening,and sixteen( 0. 05%) patients with anti-Mur escaped antibody screening tests.All the patients with anti-Mur had a history of pregnancy and/or transfusion. Of these patients with anti-Mur,two patients encountered hemolytic transfusion reaction. Conclusion The frequency of missed anti-Mur detection in some Guangxi patients was relatively high. The production of these anti-Mur were closely related to the immune stimulation of multiple pregnancies and/or blood transfusion,which can cause hemolytic transfusion reaction in some patients. In order to avoid the miss-detection of anti-Mur and ensure the safety of blood transfusion,we recommend that the blood service in Guangxi should incorporate GP.Mur+ erythrocyte for antibody screening.