低效价不规则抗体与红细胞输注无效的分析

Analysis of low titer irregular antibody and invalid red blood cell transfusion

目的调查南阳地区患者输注红细胞的临床病例,选取其中输血无效者,分析红细胞无效输注与低效价不规则抗体的漏检的相关性。方法选取在本市中心医院输注红细胞无效治疗患者570例,对患者血样用血清学试验重新分析检测是否存在低效价不规则抗体的漏检。结果红细胞输注无效患者570例(12.5%)中,女性比较男性χ2=36.81,P<0.01;有输血史与无输血史患者比较χ2=619.6,P<0.01;有妊娠史与无妊娠史患者比较χ2=85.5,P<0.01。因低效价不规则抗体漏检引起的输注无效71例,占红细胞输注无效的12.4%。结论南阳地区患者红细胞输注无效与低效价不规则抗体的漏检密切相关,低效价不规则抗体与患者输血史、妊娠史、输血次数、妊娠次数密切相关,我们常规的聚凝胺法容易漏检低效价的不规则抗体,用低效价的阳性对照试剂作对照以及改良聚凝胺法与抗球蛋白法联合检测可以提高检出率,避免该类患者因低效价不规则抗体漏检而导致无效输注。

Objective To investigate red blood cell transfusion cases among patients in Nanyang,to select invalid infusion cases,and to analyze the correlation between invalid erythrocyte infusion and low titer irregular antibodies. Methods570 cases of patients with invalid transfusion were selected in the Central Hospital. Their blood samples were analyzed by serological test to detect the presence of low titer irregular antibodies. Results Among 570 patients with invalid red blood cell transfusion（ 12. 5%）,the ratio of female： male is obtained： χ2= 36. 81,P 0. 01,indicating a significant difference. A comparison on patients with history of blood transfusion and no history of blood transfusion was delineated below： χ2= 619. 6,P 0. 01,indicating a significant difference. A comparison on patients with history of pregnancy and no pregnancy was delineated below： χ2= 85. 5,P 0. 01,indicating a significant difference. 71 cases of invalid infusion caused by low titer irregular antibody accounted for 12. 4% of the total invalid red blood cell transfusion cases. Conclusion In Nanyang,invalid blood transfusion in patients is closely related to low titer irregular antibodies. Low titer irregular antibody is correlated with a history of blood transfusion,pregnancy,number of blood transfusion and the number of pregnancy. Conventional Polybrene method can be easily used to detect low titer irregular antibodies. Using low titer of the positive control reagents as control and a combination of modified Polybrene method and antiglobulin method can improve the detection rate,which can help to avoid ineffective detection of irregular antibodies and invalid transfusion.