Rh和MNS血型系统临床输血患者不规则抗体的分布特点及意义

Distribution characteristics and significance of irregular antibodies in patients with clinical transfusion of Rh blood group system and MNS system

目的分析Rh和MNS血型系统临床输血患者不规则抗体的分布特点及意义。方法调查试验选取2014年1月至2019年1月采用微住凝胶卡方法对55789例临床输血患者进行不规则抗体筛查,统计不规则抗体筛查阳性患者,并采用谱细胞以及相关试剂对不规则抗体的特异性进行鉴别,同时还重点分析Rh和MNS系统血型中不规则抗体的分布特点以及相关疾病占比情况。结果55789例临床输血患者中共抗筛阳性患者255例,阳性率0.46%。255例患者中,男、女占比分别为35.69%、61.18%。Rh和MNS血型系统占比分别为44.71%、18.04%。在Rh血型系统中,不规则抗体从高到低的排序分别为抗-Ec(27.84%)、抗-E(10.98%)、抗-Ce(3.14%)、抗-D(1.18%)、抗-C(0.78%)、抗-Dc(0.78%)。在MNS血型系统中全部为抗-M,占比为18.04%。在78例无输血史、妊娠史患者中,Rh和MNS血型系统占比分别为44.87%、30.77%,Rh血型系统中不规则抗体从高到低的排序分别为抗-Ec(28.21%)、抗-E(14.10%)、抗-Ce(2.56%),MNS血型系统全部为抗-M,占比为30.77%。抗筛阳性患者的疾病分布情况从高到低的排序为肿瘤疾病(26.72%)、内科疾病(20.24%)、外科疾病(15.79%)、血液疾病(12.96%)、肝胆疾病(11.74%)、心血管疾病(5.67%)、妇科疾病(4.45%)、灼伤类疾病(2.43%)。结论临床输血患者中,其主要以Rh和MNS血型系统为主,Rh血型系统的不规则抗体主要以抗-Ec、抗-E为主,而MNS血型系统均为抗-M,不规则抗体筛查对于临床输血的安全性具有重要的价值和意义,输血科和临床应给予高度的关注和重视。

Objective To investigate the distribution characteristics and significance of irregular antibodies in patients with clinical transfusion of Rh blood group system and MNS system.Methods The irregular antibody screening was performed for 55,789 patients who underwent clinical transfusion in our center from January 2014 to January 2019 by micro card live gel method.The patients with positive irregular antibody were statistically calculated,and USES the spectral cells and related reagents were used to identify the specificity of irregular antibody.Moreover the distribution characteristics of irregular antibodies in Rh blood group system and MNS system as well as the proportion of related diseases were analyzed.Results Of the 55789 patients with clinical blood transfusion,255 patients were anti-screening positive,with the positive rate being 0.46%,of whom,males and females accounted for 35.69%and 61.18%,respectively.The proportion of Rh blood group and MNS blood group system was 44.71%and 18.04%,respectively.In Rh blood group system,the order of irregular antibodies from high to low was anti-Ec(27.84%),anti-E(10.98%),anti-Ce(3.14%),anti-D(1.18%),anti-C(0.78%)and anti-Dc(0.78%).In MNS blood group system,those were all anti-M,accounting for 18.04%.Among the 78 patients without blood transfusion and pregnancy history,the proportion of Rh blood type and MNS blood type system was 44.87%and 30.77%,respectively,and the order of irregular antibodies in Rh blood type system from high to low was anti-Ec(28.21%),anti-E(14.10%)and anti-Ce(2.56%),respectively,and the MNS blood type system was all anti-M,accounting for 30.77%.In order of the disease distribution of anti-screening positive patients,tumor diseases(26.72%),medical diseases(20.24%),surgical diseases(15.79%),blood diseases(12.96%),liver and gallbladder diseases(11.74%),cardiovascular diseases(5.67%),gynecological diseases(4.45%)and burns diseases(2.43%).Conclusion In the patients with clinical blood transfusion,the main type is Rh blood group system and MNS system,and the irregular antibodies in Rh blood group system are mainly anti-Ec,anti-E,with MNS blood type system being anti-M.The irregular antibody screening is of important value and significance for the safety of clinical blood transfusion,therefore,which should be paid much attention to.