军人献血者红细胞意外抗体阴性血液同型输注的安全性研究

Study on the safety of homotype transfusion of military blood donors with negative unexpected antibodies

目的了解红细胞意外抗体阴性军人献血者血液用于临床同型输注的安全性。方法以2018年11月-2019年10月在本院(同为部队血站)献血的健康、合格的军人献血者为对象,在其献血时留取血样4 mL/人(份),采用微柱凝胶技术做血型鉴定、不规则抗体筛查、直接抗球蛋白试验与交叉配血试验;统计分析这些献血者同型血液标本交叉配血的配合性。结果2018年11月-2019年10月共检测1577(人)份合格的军人献血者血样,其中A型RhD(+)者占31.39%(495/1577)、B型RhD(+)34.37%(542/1577)、O型RhD(+)24.10%(380/1577)和AB型RhD(+)160例(10.15%)。在检出并剔除意外抗体阳性者(标本)6人[意外抗体阳性率0.38%(6/1577)],对1571(人)份意外抗体阴性标本同型血液标本互相之间作了7141次交叉配血:配血率A型RhD(+)37.36%(2668/7141)、B型RhD(+)34.81%(2486/7141)、O型RhD(+)17.71%(1265/7141)和AB型RhD(+)10.11%(722/7141);仅有0.06%(1/1577,A型RhD(+))意外抗体阴性者(标本)多次与其他献血者和临床患者(标本)做交叉配血均不相合,直接抗球蛋白试验1+,故判该献血者名下的悬浮红细胞报废。结论军人献血者红细胞意外抗体阴性血液同型输注配合性高,具有较高的安全性。

Objective To analyze the safety of homotypic transfusion in military donors with negative unexpected antibody.Methods Blood samples(4 mL/person)of eligible military blood donors from November 2018 to October 2019 in our hospital(also working as forces blood station)were conducted for RBC antigen typing,unexpected antibody screening,direct antiglobulin test and cross-match test using microcolumn gel technology,and the compatibility of homotype blood samples was statistical analyzed.Results A total of 1577 samples from eligible military blood donors were collected,including A RhD(+),B RhD(+),O RhD(+)and AB RhD(+),accounting for 31.39%(495/1577),34.37%(542/1577),24.10%(380/1577)and 10.15%(160/1577),respectively.Six samples presenting positive unexpected antibodies(0.38%,6/1577)were screened out,and a total of 7141 cross-matching tests were performed on 1571 unexpected antibody negative samples,including A RhD(+)[37.36%(2668/7141)],B RhD(+)[34.81%(2486/7141)],O RhD(+)[17.71%(1265/7141)]and AB RhD(+)[10.11%(722/7141)].There was only 1 case of incompatible cross-matching presented between other donors and clinical patients,and the direct antiglobulin test was 1+,therefore suspended red blood cells of the donor were scrapped.Conclusion There was high compatibility and good security of homotypetransfusion of military blood donors with negative unexpected antibody.