肿瘤患者意外抗体分布及影响因素分析

Distribution and relative influential factors of unexpected antibody for cancer patients

目的探讨肿瘤患者意外抗体的分布情况和影响因素。方法用微柱凝集技术对本院2011年1月-2015年10月48 369例肿瘤患者标本进行抗体筛查实验,阳性结果依据2010版AABB抗体鉴定指南进行抗体鉴定,分析肿瘤患者意外抗体分布特点。结果 255例患者意外抗体阳性,阳性率0.53%;意外抗体以抗-M(57/22.35%)、抗-Lea(54/21.18%)及抗-E(53/20.78%)居多。多因素Logistic回归分析显示患者结直肠肿瘤、淋巴瘤、是否转移、输血史、性别、怀孕次数、及Rh D血型对意外抗体产生有影响(OR=1.811、2.782、3.484、1.994、1.462、1.667、2.999,均为P<0.05)。结论肿瘤患者的意外抗体产生与疾病、输血史、性别等多种因素有关;根据抗体分布特点定期筛查部分库存血的Rh、MNS等血型系统抗原,能够快速满足肿瘤患者用血需求,保证临床输血治疗的安全与有效。

Objective To investigate the distribution and associated factors of unexpected antibody in cancer patients.Methods CAT（ column agglutination technique） had been used to screen unexpected antibody of 48 369 cancer patients in our hospital from January 2011 to October 2015,according to the 2010 version of AABB guidelines for antibody identification. Results Unexpected antibody has been found in 255 patients at a total rate of 0. 53%. anti-M antibody occurred most（ 57 /22. 35%）,followed by anti-Lea antibody（ 54 /21. 18%） and anti-E antibody（ 53 /20. 78%） and other uncommon unexpected antibody,which was associated with colorectal cancer,lymphoma,metastasis,blood transfusion history,gender,pregnancies and labors and Rh blood group based on multivariable Logistic regression analysis. Conclusion The generation of unexpected antibody of cancer patients is influenced by many factors,such as diseases,transfusion history,gender,etc.Regular screening of Rh and MNS blood group based on the distribution of unexpected antibody may meet cancer patients＇ demand for blood transfusion and guarantee the safety and effectiveness of clinical blood transfusion.