定期输血地中海贫血患者血清抗体检测

Detection of serum antibodies in regularly transfused patients with Mediterranean anemia

目的定期输血患者血清抗体测定和特异性分析。方法采用微柱凝胶抗人球卡方法,对354例长期定期输血的β-地中海贫血患者,进行血清抗体筛查和抗体鉴定。结果 354人中,28人抗体阳性(7.9%),其中13人检出同种抗体(1人无法确定抗体特异性),15人检出自身抗体。共检出特异性同种抗体19个,其中Rh血型抗体15个(78.9%),包括抗-c、抗-E、抗-C和抗-Cw;自身抗体中,1例具有特异性,为抗-C,5例血清与所有鉴定细胞强凝集,均报输血不良反应,其余9人血清与同种细胞弱反应,均未报输血反应。另外,观察到18人次侧配血凝集(5.1%),但血清不与同种细胞反应即主侧配血相合,或因多次输血异体血浆蛋白吸附或药物抗体等原因引起,均未报输血反应。结论长期定期输血的地中海贫血患者血清同种抗体和自身抗体的比率较高,同种抗体以Rh血型抗体为主,应进行Rh Cc Ee相合输血。

Objective Determination and analysis of the specificity of serum antibody in the regularly transfused patients. Methods By a micro column gel method,serum antibody screening and identification were performed in 354 patient cases with beta-Mediterranean anemia and long-term regular blood transfusion requirements. Results In all 354 patients,28 were antibody screened positive（ 7. 9%）. 13 of them were detected alloantibodies（ fail to confirm the specificity of one sample）,15 patients detected autoantibodies. A total of 19 alloantibodies were identified. 15 were Rh antibodies（ 78. 9%）,including anti-c,anti-E,anti-C and anti-Cw. In the autoantibody positive patients,one was anti-C specific and the rest were reactive to both patient red blood cells and all screening and panel reagent cells. only 5 patients reported transfusion reactions with more than 2＋ positive in penal cell reactions,. Furthermore,we observed 18 patients exhibiting DAT positive and minor cross matching positive,but not in major cross matching tests. This might be caused by plasma protein adsorption due to multiple blood transfusions or drug antibodies. Conclusion Alloantibodies Autoantibodies are frequently presented in these Mediterranean anemia patient with long term regular transfusion. The Alloantibodies,in particular,were mostly Rh blood group antibodies. Therefore regular RhCcEe matched transfusion is necessary.