海南地中海贫血输血患儿不规则抗体检测

Detection of Irregular Antibodies after Blood Transfusion for Children with Thalassemia in Hainan

目的:了解海南地区长期输血的地中海贫血患儿不规则抗体阳性率及抗体特异性并分析其产生原因。方法:采用微柱凝胶法对在本院接受输血治疗的49例地中海贫血患儿进行不规则抗体筛查,对抗体筛查阳性标本进行抗体特异性鉴定。结果:14例患儿出现抗体筛查阳性,抗体特异性鉴定检出Rh血型抗体11例,不规则抗体和自身抗体同时存在1例,抗-JK^a和抗-JK^b各1例。男、女性抗体筛查阳性率分别为16.1%(5/31)和50.0%(9/18),女性抗体筛查阳性率高于男性。汉、黎族抗体筛查阳性率分别为18.4%(7/38)和63.6%(7/11),黎族抗体筛查阳性率高于汉族。开始治疗时间在出生-6月龄、6月龄-1岁和1岁以上出现抗体筛查阳性的例数和百分比分别为3例(15.8%)、3例(20.0%)和8例(53.3%)。α地中海贫血3例抗体筛查均阴性、β地中海贫血抗体筛查阳性4例(14.8%)、αβ混合型地中海贫血抗体筛查阳性9例(60.0%)、未明确地中海贫血类型的抗体筛查阳性1例(25.0%),αβ混合型地中海贫血患儿输血后抗体筛查阳性率最高。以上差异均有统计学意义(P<0.05)。但从ABO血型来比较抗体筛查阳性率之间的关系显示,差异无统计学意义(P>0.05)。结论:地中海贫血患儿长期输血后产生抗体大多属于Rh同种抗体;混合型地中海贫血患儿更易产生抗体;黎族抗体筛查阳性率高于汉族,这可能是由黎汉族之间存在的血型基因差异导致。

Objective:To investigate the irregular antibody positive rate and antibody specificity in children with thalassemia received long-term blood transfusion in Hainan area and analyze the causes of antibody screening positive.Methods:Micro-column gel method was used to screen the irregular antibody in 49 children who received transfusion treatment in our hospital,and the antibody specificity of the positive samples was evaluated.Results:Fourteen of 49 cases showed positive for screening.Among them,11 cases showed Rh blood group antibody after detecting antibody specificity,1 case showed the coexistence of irregular antibody and autoantibody.One case for anti-JK^a and 1 case for anti-JK^b.The positive rate of antibody screening was 16.1%(5/31)in males and 50.0%(9/18)in females.The positive rate of antibody screening was higher in females than that in males.The positive rate of antibody screening in Han and Li nationality was 18.4%(7/38)and 63.6%(7/11),respectively.The positive rate of antibody screening in Li nationality was higher than that in Han nationality.After starting blood transfusion treatment,there were 3 cases(15.8%)of antibody screening positive at birth to 6 months old,Three cases(20.0%)of antibody screening positive at 6 months to 1 year old and 8 cases(53.3%)of antibody screening positive at over 1 year old.Three cases withα-thalassemia were negative after screening.Four cases(14.8%)withβ-thalassemia were positive after screening.Nine cases(60.0%)withαβthalassemia were positive after screening,1 case(25.0%)with undefined type of thalassemia was positive after screening.The positive rate of antibody screening after blood transfusion was highest in children withαβmixed type of thalassemia.Above-mentimed differences were statistically significant(P<0.05).But there was no significant difference between the positive rate of screening by ABO blood group(P>0.05).Conclusion:Most of the antibodies produced after long-term blood transfusion in the children with thalassemia belong to Rh blood group antibodies;the children with mixed thalassemia are more likely to produce antibodies;the antibody screening positive rate of Li nationality is higher than that of Han nationality,which may be caused by the genetic difference of blood type between Li nationality and Han nationality.