14273例拟输血患者不规则抗体筛查结果分析

Analysis of the Results of Irregular Antibody Screening in 14273 Patients with Blood Transfusion

目的:对拟输血患者用微柱凝胶法筛检不规则抗体检出及分布情况进行分析。方法:选取14 273例拟输血患者作为研究对象,均采用微柱凝胶法筛检不规则抗体,其中,阳性患者均采用谱细胞进行抗体的特异性分析。结果:14 273例患者中,检出97例患者存在不规则抗体,阳性检出率0.68%(97/14 273)。其中,MNS系统中共有17例患者,占比17.53%(17/97);Rh系统中共有54例患者系统中共有54例患者,占比55.67%(54/97)。免疫球蛋白M(IgM)类中有23例患者,占比23.71%(23/97);免疫球蛋白G(IgG)中有63例患者,占比64.95%(63/97);IgM+IgG有11例患者,占比11.34(11/97)。14 273例患者中,筛查4 281例男性,19例阳性,阳性率为0.44%(19/4 281);筛查9 992例女性,78例阳性,阳性率0.78%(78/9 992),女性不规则抗体阳性检出率高于男性,差异有统计学意义(χ~2=5.037,P<0.05)。85例有输血/妊娠史患者,阳性检出率0.95%(85/8 965),12例无输血/妊娠史患者,阳性检出率为0.24%(12/5 308),有输血/妊娠史患者规则抗体阳性检出率相高于无输血/妊娠史患者,差异有统计学意义(χ~2=25.752,P<0.05)。不规则抗体阳性患者临床科室分布,血液内科占比最高,阳性检出率为5.20%(15/290),其次为肾脏风湿科,阳性检出率为2.80%(10/360)。结论:抗体筛查阳性的不规则抗体性质以同种免疫产生IgG抗体为主,最常见为Rh系统抗体,其中以抗-E最多;有输血史和妊娠史的患者检出率更高;女性检出率高于男性;血液内科、肾脏风湿科的患者检出率较高。应对拟输血的患者进行不规则抗体筛选,从而有助于降低患者溶血性输血反应及预防新生儿溶血病,提高输血有效性安全性和保障母婴安全。

Objective:To analyze the detection and distribution of irregular antibody in blood transfusion patients by microcolumn gel method.Method:A total of 14 273 patients with blood transfusion were selected as the research objects.The irregular antibody were screened by microcolumn gel method.Spectral cells were used to analyze the specificity of antibody in all positive patients.Result:Among the 14 273 patients,97 patients had irregular antibody,and the positive detection rate was 0.68% (97/14 273).Among them,there were 17 patients in MNS system,accounting for 17.53% (17/97).There were 54 patients in Rh system,accounting for 55.67% (54/97).There were 23 patients with immunoglobulin M (IgM),accounting for 23.71% (23/97).There were 63 patients with immunoglobulin G (IgG),accounting for 64.95% (63/97).There were 11 patients with IgM+IgG,accounting for 11.34 (11/97).Among the 14 273 patients,4 281 males were screened,19 were positive,the positive detection rate was 0.44% (19/4 281).Among the 9 992 female screened,78 were positive,the positive detection rate was 0.78% (78/9 992).The positive detection rate of irregular antibody in female was higher than that in male,and the difference was statistically significant (χ~2=5.037,P<0.05).A total of 85 patients with blood transfusion/pregnancy history,the positive detection rate was 0.95% (85/8 965),12 patients without blood transfusion/pregnancy history,the positive detection rate was 0.24% (12/5 308).The positive detection rate of regular antibody in patients with blood transfusion/pregnancy history was higher than that in patients without blood transfusion/pregnancy history,and the difference was statistically significant (χ~2=25.752,P<0.05).Distribution of clinical departments of irregular antibody positive patients:hematology department accounted for the highest proportion,the positive detection rate was 5.20% (15/290),followed by renal rheumatism department,the positive detection rate was 2.80% (10/360).Conclusion:Antibody screening positive irregular antibody nature of IgG antibody,the most common is the Rh system antibody,of which anti-E is the most.Patients with a history of blood transfusion and pregnancy has higher detection rates.Female detection rate is higher than male.The detection rate of patients with hematology and renal rheumatism department is higher.Irregular antibody screening should be carried out for patients to be transfused,so as to help reduce hemolytic transfusion reaction of patients and prevent hemolytic disease of newborn,improve the efficacy and safety of blood transfusion and ensure the safety of mother and child.