低效价不规则抗体漏检及其与无效输血的关系研究

Study on the relationship between low titer irregular antibody undetected and invalid blood transfusion

目的低效价不规则抗体漏检及其与无效输血的关系研究。方法采用模拟试验筛选检测低效价不规则抗体的敏感方法;分析比较无效输血组与有效输血组相关临床因素;比较无效输血组与有效输血组用敏感方法检测的抗筛结果。结果抗体效价为2时,凝聚胺法、抗球蛋白法开始出现漏检,抗球蛋白增强法无漏检;抗体效价为1时,凝聚胺法、抗球蛋白法漏检例数增高,抗球蛋白增强法对低效价不规则抗体检出效果最好。红细胞输注无效率为15.0%(181/1 207),46例无效输血组与1 026例有效输血组性别和年龄比较统计学处理无差异(P>0.05);妊娠次数、输血次数比较统计学处理有差异(P<0.05)。46例无效输血病例检出不规则抗体37例,2例抗体效价>2,10例抗体效价为2,25例抗体效价为1,低效价抗体导致的无效输血率为76.1%(35/46)。结论低效价抗体漏检是无效输血的原因之一,建议对有输血史、妊娠史的患者抗体筛查采用抗球蛋白增强法。

Objective To study the relationship between low titer irregular antibody undetected and invalid blood transfusion. Methods Simulation test was adopted to screen a sensitive method for the detection of low titer irregular antibody.Analysis the related clinical factors between invalid and effective blood transfusion groups. Then compare the screening results using the sensitive method between that two groups. Result When the titer of antibody was 2,Polybrene method and anti globulin method began to appear undetection,but undetective phenomenon could not be seen using anti globulin enhancement method. When the titer of antibody was 1,the failed cases were increasing using Polybrene method and anti globulin method,on the contrary,anti globulin enhancement method was most efficient. The rate of invalid transfusion was 15.0%（ 181 /1207）. Gender and age were no statistical difference between 46 cases of invalid blood transfusion group and 1026 cases of effective blood transfusion group（ P 〉 0. 05）. The number of pregnancy and the time of blood transfusion had statistical difference between that two group（ P 〈 0. 05）. Among the 37 cases of irregular antibody detected in 46 cases of invalid blood transfusion cases,2 cases of antibody titer was higher than 2,10 cases of antibody titer was 2,25 cases of antibody titer was 1. The rate of invalid transfusion due to the low titer antibody was 76. 1%（ 35 /46）. Conclusion The missed detection of low titer antibody was one of the causes of invalid transfusion. Anti globulin enhancement method for antibody screening should be adopted when there was a history of blood transfusion or pregnancy.