33157例患者血型不规则抗体筛查的结果分析

Analysis of irregular antibody screening results in 33157 hospitalized patients

目的:通过对本院住院患者血清不规则抗体筛查结果的分析,探讨血型不规则抗体筛查在临床输血中的意义。方法:应用微柱凝胶免疫检测技术对本院2015年8月至2016年7月33157名住院患者进行不规则抗体筛查,并将阳性结果复查后再采用谱细胞分析,确定不规则抗体的特异性。结果:1)在33157名患者中共查出不规则抗体阳性101例,占0.30%,其中女性患者阳性率为0.420%,高于男性患者(0.181%),差异有统计学意义(P<0.01)。2)61例患者接受了抗体类型鉴定,其中检出特异性抗体42例(68.85%),包括Rh系统患者31例(50.82%),MNS系统患者8例(13.11%),Lewis系统患者2例(3.28%),抗-Ec合并抗-Mur患者1例(1.64%);非特异性抗体患者15例(24.59%),包括自身抗体7例(11.48%),冷抗体3例(4.92%),自身抗体合并同种抗体5例(8.20%);性质不明抗体4例(6.56%)。3)按临床科室划分,不规则抗体检出率以风湿免疫科患者最多,占4.67%,其次为血液科患者,占1.71%,内科患者占0.49%,产科患者占0.33%。结论:输血前血型不规则抗体的筛查与种类鉴定非常必要,及早发现有临床意义的不规则抗体,减少溶血性输血反应,保证患者输血安全。

Objective:Red blood cell irregular antibodies were analyzed in hospitalized patients to ensure safty of blood transfusion.The type of antibodies and distribution were investigated to explore the significance in clinical transfusion.Methods:Irregular antibodies screening was performed with microcolumn gel method in 33157 hospitalized patients between August 2015 and July 2016.The positive results were reviewed and further analyzed to identifiy the specificity of irregular antibodies.Results:1) 101 cases of irregular antibodies were detected accounting for 0.30% with 72 females (0.402%) and 29 males ( 0.180%) Female patients had a significantly high positive rate compared with male(P<0.05).2) Of 61 positive samples for further antibody specificity,42 cases were identified as specific antibodies,including 31 cases of Rh group (50.82%),8 cases of MNS group (13.11 %),2 cases of Lewis group (3.28%),and 1 case of anti-Ec combined with anti-Mur,while 15 cases as non-specific antibodies,including 7 cases of auto antibodies,3 cases of cold antibodies,5 cases of autoantibodies combined with specific antibodies and 4 cases of others.3) The distribution of positive irregular antibodies in different clinical departments:rheumatology department with a highest rate at 4.67%,followed by hematology department (1.71%),internal medicine department (0.49%) and obstetrical department (0.33%).Conclusion:It is essential to perform irregular antibodies screening and identification for patients before transfusion,which is of great significance for ensuring blood transfusion safety and reducing adverse transfusion reaction.