新建医院患者ABO血型表型与不规则抗体结果的分析及其应用

Analysis and application of ABO blood type phenotypes and irregular antibody results in the newly built hospital

目的掌握新建综合医院患者血型表型及不规则抗体的结果并探讨其应用。方法回顾统计该院2016年3月至2018年2月患者ABO、RhD血型表型结果、红细胞悬液使用情况、不规则抗体筛查、部分抗体鉴定结果。结果 ABO血型表型总分布频率特征与红细胞悬液使用比例特征均为O>A>B>AB;RhD阴性频率为0.4%,以妇产科患者所占比例最高;ABO血型在不同性别及RhD阴性、阳性分布中的差异均无统计学意义(P>0.05)。4 032例标本中不规则抗体筛查阳性率为0.7%(29/4 032);女性阳性率(0.8%,22/2 590)虽高于男性阳性率(0.5%,7/1 442),但差异无统计学意义(P>0.05);有妊娠史病例阳性率(0.9%,20/2 251)高于无妊娠史(0.5%,9/1 781),但差异无统计学意义(P>0.05);有输血史病例阳性率(3.6%,12/326)高于无输血史病例阳性率(0.5%,17/3 706),差异有统计学意义(P<0.05);既有输血史也有妊娠史的病例阳性率(4.5%,5/112)高于其他患者(0.6%,24/3 920),差异有统计学意义(P<0.05)。6例经鉴定为自身抗体2例,抗M抗体2例,抗Fya、抗Jka各1例。结论该新建医院可参考患者血型表型分布特征来制订、动态调整血液贮存计划,且需不断提升实验室筛查与鉴定不规则抗体能力来确保输血安全、有效。

Objective To study the results of blood type phenotypes and irregular antibody screening for patients in newly built general hospital,and to discuss the application.Methods From March 2016 to February 2018,the results of ABO,RhD blood type phenotypes,the application of red cells suspension,the results of irregular antibody screening and the partial results of antibody identification in our hospital were retrospectively analyzed.Results Consistently,both of the frequency distribution of ABO blood type phenotypes and the proportion of the used total red cells suspension were O>A>B>AB.RhD negative frequency was 0.4%,and the proportion of obstetrics and gynecology patients was the highest.There was no significant difference in ABO blood group between different genders and the distribution of RhD negative and positive(P>0.05).The positive rate of irregular antibody screening in 4032 samples was 0.7%(29/4032);the positive rate in women(0.8%,22/2590)was higher than that in men(0.5%,7/1442),but there was no significant difference(P>0.05);the positive rate in cases with pregnancy history(0.9%,20/2251)was higher than that in cases without pregnancy history(0.5%,9/1781),but there was no significant difference(P>0.05).The positive rate of cases with blood transfusion history(3.6%,12/326)was higher than that without blood transfusion history(0.5%,17/3706),the difference was statistically significant(P<0.05);the positive rate of cases with both blood transfusion history and pregnancy history(4.5%,5/112)was higher than that of other patients(0.6%,24/3920),the difference was statistically significant(P<0.05).Six cases were identified as autoantibodies in 2 cases,anti-M antibodies in 2 cases,anti-Fya and anti-Jka in 1 case respectively.Conclusion The new hospital can draw up and dynamically adjust the blood storage plan by referring to the characteristics of blood phenotype distribution.It also needs to constantly improve the ability of laboratory screening and identification of irregular antibodies to ensure the safety and effectiveness of blood transfusion.