8385例患者输血前意外抗体筛查结果分析

Screening of unexpected antibodies in patients before blood transfusion

目的回顾分析输血前患者意外抗体筛查结果,探讨输血前意外抗体筛查的意义。方法采用微柱凝胶法对2012年1月至2013年12月柏乡县人民医院8 385例患者输血前进行意外抗体筛查(观察组),筛查阳性者用谱细胞做特异性鉴定。将未进行输血前意外抗体筛查的7 630例患者作为对照组,比较两组患者筛查前后的输血不良反应发生率。结果8 385例输血患者共检出意外抗体59例,阳性检出率为0.70%,特异性意外抗体51例,阳性检出率为0.61%,以Rh系统和MNS系统多见,分别占40.68%(24/59)和16.95%(10/59)。意外抗体大多为Ig G,占67.80%(40/59)。女性患者意外抗体阳性检出率高于男性(P<0.05)。意外抗体的阳性检出率与多次输血及妊娠史有关(P<0.01)。意外抗体引起的输血不良反应主要为溶血性输血反应,观察组输血不良反应发生率明显低于对照组(P<0.01)。结论本地区输血患者有一定的意外抗体检出率,在输血前对输血患者进行意外抗体筛查,可避免输入含有相应抗原的血液,对于保证患者的输血安全具有重要意义。

Objective To analyze the screening results of unexpected antibodies in patients before blood transfusion retrospectively, and discuss the meaning of unexpected antibodies screening before blood transfusion. Methods 8 385 cases of patients before transfusion were screened for unexpected antibodies by using Microcolumn gel method（MGT） from January 2012 to December 2013, and specific identification was given to the positive samples by spectral cells. 7 630 cases of no screening before blood transfusion from 2010 to 2011 were used for comparison. The incidences of transfusion reactions in two groups were compared. Results 59 cases of unexpected antibodies were detected out of 8 385 cases of patients before blood transfusion, with a positive rate of 0.70%, including 51 cases of specific antibody and positive rate was 0.61%. They were mainly Rh system and MNS system, accounted for 40.68%（24 / 59） and 16.95%（10 / 59）respectively. The positive rate of unexpected antibodies in female was higher than that in male（P 〈0.05）, the positive rate was associated with multiple blood transfusions and pregnancies（P 〈0.01）. Unexpected antibodies caused mainly hemolytic transfusion reaction. Blood transfusion reaction rate after screening was lower than that in the group without screening, the difference had statistical significance（P 〈0.01）. Conclusion The screening results of unexpected antibodies in patients before blood transfusion was obtained. The screening of unexpected antibody in patients before blood transfusion could avoid the transfusion of the blood that contains the corresponding antigens, to assure the safety of blood transfusion.