24743例拟输血患者不规则抗体筛查结果及分析

Screening Results and Analysis on Irregular Antibody in 24743 Patients for Selective Blood Transfusion

目的对本院拟输血患者不规则抗体检查结果分析,探讨红细胞不规则抗体的发生率和分布特点,给临床安全输血提供依据。方法对住院部2016年1月-2017年1月24743例拟输血患者应用盐水法和微柱凝胶法行血型不规则抗体检测,并对阳性标本进行抗体鉴定分析。结果 24743例患者中发现不规则抗体阳性138例(占总数的0.56%)。除去重复入院的患者后,还有132例不规则抗体阳性,101例既往有输血/妊娠史。其中男性不规则抗体阳性46例(占34.9%),女性阳性86例(占65.1%)。不规则抗体主要为:Rh系49例,MNSs系22例,Lewis系17例,其中抗-E、抗-M、抗-Lea检出率最高。132例不规则抗体阳性中,产科和血液内科阳性患者最多,其合计占62.12%。结论拟输血患者中女性产生不规则抗体阳性率高于男性;有妊娠史/输血史的患者比无输血史/妊娠史的患者更易产生不规则抗体;拟输血患者输血前做不规则抗体检测必不可少。

Objective To analyze the results of irregular antibody in the patients for selective blood transfusion and explore the incidence and distribution of irregular antibody of red blood cells so as to provide the evidences for the clinical safety of blood transfusion. Methods From January 2016 through to January2017,the saline method and microcolumn gel method were adopted to test the irregular antibody of blood type. The identificantion analysis was done for the samples with positive results. Results Of 24743 cases,138 cases were positive in irregular antibody（ accounting for 0. 56%）. Except the cases with repeated admission,there were 132 cases with positive results and 101 cases with the history of blood transfusion or pregnancy. Of these cases,there were 46 males（ accounting for 34. 9%） and 86 females（ 65. 1%）. The main irregular antibodies were： 49 cases of Rh series,22 cases of MNSs series and 17 cases of Lewis series. The highest incidences occurred in anti-E,anti-M and anti-Le^a. Of 132 cases with positive results,the most patients were in the departments of obstetrics and hematology,accounting for 62. 12%. Conclusion The incidence of the positive irregular antibody in females was higher than the males. The patients with the history of pregnancy or blood transfusion were more apt to have irregular antibody as compared with those without the history of blood transfusion or pregnancy. It is necessary to have the test of irregular antibody for the patients with selective blood perfusion.