3774例孕妇红细胞不规则抗体筛查的调查分析

Investigation and Analysis of 3774 Pregnant Women With Irregular Red Blood Cell Antibody Screening

目的分析不规则抗体筛查在常规孕期检测中的重要性。方法选取2019年1—12月就诊的3774例孕妇,应用全自动微柱凝集血型检测系统进行不规则抗体检测,并对阳性标本鉴定抗体特异性。结果3774例孕妇检测出不规则抗体45例,同期15687例非孕患者不规则抗体筛查阳性77例,孕妇抗体筛查阳性率明显高于非孕患者(P<0.01)。有妊娠史、输血史的孕妇不规则抗体的阳性率明显高于无妊娠史和输血史的孕妇(P<0.05)。检出的不规则抗体主要涉及Rh系统、MNS系统、Lewis系统,抗体的类型有抗-E、抗-D、抗-M、抗-Lea等,其中抗-M检出率最高(13例,28.89%)。本次研究中一例产生IgG性质的抗-HI抗体的类孟买A型(OHmA)孕妇,通过自身储血,解决患者的用血困难。结论对孕妇进行不规则抗体筛查有利于早期确定有临床意义的抗体,对于早期诊断和治疗新生儿溶血病,保障孕妇输血安全具有重要意义。

Objective To analyze the importance of irregular antibody screening in routine pregnancy detection.Methods Atotal of 3774 pregnant women who visited the hospital from Januaryto December 2019 were selected for irregular antibody detection using the automatic microcolumn agglutination blood group detection system,and the antibody specificity of the positive samples was identified.Results 45 cases of 3774 pregnant women were detected with irregular antibody,while 77 cases of 15687 nonpregnant patients were positive for irregular antibody screening,indicating that the positive rate of maternal antibody screening was significantly higher than that of non-pregnant patients(P<0.01).The positive rate of irregular antibody in pregnant women with pregnancy history and blood transfusion history was significantly higher than that in pregnant women without pregnancy history and blood transfusion history(P<0.05).The detected irregular antibodies mainly involved Rh system,MNS system and Lewis system,the types of antibodies are anti-E,anti-D,anti-M,antiLea,etc.,of which the detection rate of anti-M was the highest(13 cases,28.89%).In this study,A case of OHmApregnant woman who produced IgG anti-HI antibodies was able to solve the difficulty of using blood through self-storage of blood.Conclusion Irregular antibody screening in pregnant women is beneficial to the early determination of clinically significant antibodies,for the early diagnosis and treatment of hemolytic disease in newborns,and to ensure the safety of blood transfusion in pregnant women.