低效价不规则抗体漏检与无效输血的关系及解决对策

Relationship between misdetection of low-titer irregular antibodies and invalid red blood cell transfusion and its solution

目的了解武威地区低效价不规则抗体漏检与红细胞无效输注的相关性,并提出解决对策。方法对2017年1月-12月武威地区5所医院3 554例输血病例进行追踪调查,发现无效输注病例516例,对516例无效输注病例采用盐水法、凝聚胺法、抗球蛋白法进行原因分析,检测体内是否存在低效价不规则抗体;对低效价不规则病例与输血病例进行临床资料相关因素分析以及统计学分析比较,找出差异性。结果有52例患者体内存在低效价不规则抗体,占无效输血病例的10.08%,占总输血病例的1.47%。男、女含有低效价不规则抗体的比例比较;1-2次、3次以上输血病例比较及1-2次、3次以上妊娠史病例比较,均发现有统计学意义的差异(P<0.05)。结论武威地区红细胞无效输注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输血史、输血次数、妊娠史、妊娠次数有密切关系,对高危人群选择合适的检测方法做抗体筛选和鉴定,做到"精准输血",避免红细胞输泩无效的发生。

Objective The study the correlation between misdetection of low-titer irregular antibodies and invalid RBC transfusion in Wuwei area, Gansu, and to propose some countermeasures. Methods 516 cases of invalid transfusion out of a total of 3554 cases of RBC transfusion from 5 hospitals in Wuwei area were traced out after follow-up. The 516 invalid cases underwent salt method, agglutination method, and anti-globulin method to identify the low-titer irregular antibodies. The differences of relevant factors between low-titer irregular antibody cases and other invalid RBC transfusion cases was analyzed though comparing.Results There were 52 patients with low-titer irregular antibodies, accounting for 10.08 % of invalid blood transfusion cases and 1.47 % of total RBC transfusion cases. Comparison of the ratio of low-titer irregular antibodies between male and female showed significant difference(P<0.05). Significant difference in the detection rate of low-titer irregular antibodies was observed between patients with numbers of blood transfusion of 1-2 and beyond 3. So was between patients with numbers of pregnancy of 1-2 and beyond 3.Conclusion The invalid RBC transfusion in Wuwei area is closely related to the misdetection of low-titer irregular antibodis. Patients with multiple times of blood transfusion and pregnancy are high-risk groups and precise transfusion after irregular antibodies screening and identification must be put into consideration to ensure effective blood transfusion.