血型不规则抗体筛查在精准输血管理中的应用

Application of irregular antibodies screening in the precise transfusion management

目的探讨不规则抗体输血患者行个性化输血方案,实现精准化输血。方法对输血患者行不规则抗体筛查,阳性者再行特异性抗体鉴定,创建阳性者数据库。结果 10 155例患者中筛检出不规则抗体阳性32例,阳性率为0.32%;其中特异性抗体23例(71.87%),涉及5个血型系统:Rh血型系统15例(46.88%),含抗-Ec抗体9例、抗-D抗体5例及抗-Ce抗体1例;Duffy血型系统3例(9.38%),含抗Fya抗体1例,抗Fyb抗体2例;MNSs血型系统2例(6.25%),含抗-M抗体和抗-S抗体各1例;P血型系统2例(6.25%),含抗P1抗体2例;Kidd血型系统1例(3.12%),含抗Jkb抗体1例;非特异性抗体9例(28.12%),含自身抗体9例(排除冷凝激素2例的干扰)。20例患者进行了精准输血治疗的干预,均未发生输血不良事件。结论对不规则抗体筛查阳性患者进行动态管理可以降低不良事件发生的概率,降低患者输血的风险;输血科应创建阳性患者数据库,迅速准确地选择匹配的血制品,以保证临床输血安全、有效、快捷。

Objective To explore the individualized blood transfusion scheme for patients with irregular antibody blood transfusion,so as to realize accurate blood transfusion.Methods Irregular antibody screening was carried out on the patients with blood transfusions,and specific antibody identification was performed on positive patients in order to create a database of positive patients.Results Among 10155 patients,32 cases were positive for irregular antibody,the positive rate was 0.32%.Among them,23 cases(71.87%)of specific antibodies involved 5 blood group systems:15 cases(46.88%)of Rh blood group system contained 9 cases of anti-Ec antibody,5 cases of anti-d antibody and 1 case of anti-Ce antibody.3 patients(9.38%)with Duffy blood group system contained 1 anti-Fya antibody and 2 anti-Fyb antibody.There were 2 cases(6.25%)of MNSs blood group system,including 1 case of anti-M antibody and 1 case of anti-S antibody.2 patients(6.25%)with P blood group system contained anti-P1 antibody.1 case(3.12%)of Kidd blood group system contained anti-Jkb antibody.9 cases(28.12%)of non-specific antibodies contained autoantibodies(excluding 2 cases of condensation hormones).Among them,20 patients were treated with accurate blood transfusion,and no adverse reactions occurred.Conclusions Dynamic management of positive patients with irregular antibody screening can largely reduce the incidence of transfusion reactions,and reduce the risk of blood transfusion.The database of irregular antibodies and blood type information should be established in the department of blood transfusion,so as to quickly and accurately select the matching blood products to ensure the safety,effectiveness and rapidity of clinical blood transfusion.