血型不规则抗体检测及特异性鉴定结果回顾分析

Retrospective analysis of erythrocyte blood type irregular antibody detection and specificity appreciation

目的:观察27600例临床申请输血患者红细胞血型不规则抗体检测及特异性鉴定结果.方法:选取2018年5月~2020年4月扶沟县人民医院和周口市中心医院收治申请输血治疗的27600例患者为研究对象,微柱凝胶检测所有患者血清中不规则抗体,检测结果阳性患者应用谱细胞鉴定抗体特异性.结果27600患者中不规则抗体阳性141例(0.51%),主要为抗-E(44例,31.21%)、抗-M(20例,14.18%)和温自身抗体(21例,14.89%);不规则抗体阳性多见于肿瘤、慢性肾脏疾病和血液系统疾病,不同疾病间抗体阳性率比较有显著差异(P<0.05);抗体阳性病例中女性阳性率高于男性,有输血史、妊娠史患者阳性率高于无输血史、无妊娠史,60岁以上患者抗体阳性率高于60岁以下患者,均有显著差异(P<0.05);抗体阳性患者与谱细胞凝集反应≤2+者为123例(87.23%).结论申请输血治疗患者不规则抗体阳性率为0.51%,主要为抗-E、温自身抗体和抗-M,输血前进行不规则抗体检查可确保输血安全,减少或避免免疫性输血不良反应的发生..

Objective:To observe the results of erythrocyte blood type irregular antibody detection and specificity appreciation in 27600 patients with blood transfusions.Methods:From May 2018 to April 2020,a total of 27600 patients who were apply for blood transfusion therapy in Fugou people's hospital and Zhoukou central hospital as selected as research object,irregular antibody was detected by by microcolumn gel method,and antibody identification was performed for the positive samples by spectral cell.Results:Among the 27600 patients,141 positive screening results were detected(0.51%),main including anti-E(44 cases,31.21%),anti-M(20 cases,14.18%)and warm autoantibody(21 cases,14.89%);The positive rate was higher in patients who had tumor,hematologic disease and chronic renal disease,the antibody positive rate in different disease were statistically significant(P<0.05);The positive detection rate of irregular antibody in female patients was significantly higher than that in male patients,the positive detection rate in patients with pregnancy history and blood transfusion history were higher than that in no pregnancy history and no blood transfusion history,the positive detection rate in patients above 60 year was higher than patients below 60 year,there were significant deviation(P<0.05);The patients of agglutination reaction titer≤2+was 123 cases(87.23%).Conclusion:The irregular antibody positive rate was 0.51%in patients with blood transfusion therapy,main including anti-E,anti-M and warm autoantibody,before blood transfusion,detection of irregular antibody in patients can ensure the safety of blood transfusion,reduce or avoid the immunity hemolytic transfusion reactions.