佛山地区无偿献血者红细胞血型不规则抗体筛查及鉴定结果研究

A study on the results of screening and identification of red blood cells irregular antibodies of blood donors in Foshan area

目的 对佛山地区 90000 例无偿献血者的血液进行不规则抗体筛查及鉴定 , 分析其筛查鉴定价值。方法 90000 例无偿献血者 , 均进行血型检查、不规则抗体初步筛查 , 对于初步筛查结果显示为阳性、ABO 正反定型不一致的献血者再次进行不规则抗体检测 , 对抗体[免疫球蛋白 G(IgG)、免疫球蛋白 M(IgM)]的类别进行鉴定。分析献血者血液标本不规则抗体阳性检出情况;比较不同性别、有无妊娠史献血者不规则抗体阳性率 , 不同献血次数、年龄献血者不规则抗体阳性率。结果 90000 例献血者中共筛查出不规则抗体阳性 58 例 (0.06%), 其中特异性抗体 48 例 , 抗体的主要类型为抗 -E、抗 -M其余 10 例为非特异性抗体 , 抗体的主要类型为冷自身抗体。90000 例献血者中女性不规则抗体阳性率为 0.10%(45/47011), 高于男性的 0.03%(13/42989), 差异有统计学意义 (P<0.05);且女性献血者中有妊娠史献血者不规则抗体阳性率为 0.15%(35/24081), 高于无妊娠史献血者的 0.04%(10/22930), 差异有统计学意义 (P<0.05)。90000 例献血者中初次献血者的不规则抗体阳性率 0.14%(37/27839) 高于献血次数≥2 次献血者的 0.04%(21/62161), 差异有统计学意义 (χ^(2)=29.335, P<0.05);不同年龄献血者不规则抗体阳性率比较差异有统计学意义 (P<0.05), 并且献血者的年龄越大 , 不规则抗体阳性率越高 , 凝集强度≤++ 的献血者高达 52 例 (89.66%)。结论 佛山地区无偿献血者血液中红细胞血型不规则抗体阳性率较低 , 以抗 -E、抗 -M 和冷自身抗体为主 , 血站需加强红细胞血型不规则抗体的筛查及鉴定。

Objective To screen and identify irregular antibodies in the blood of 90000 cases of unpaid blood donors in Foshan area and analyze their screening and identification value. Methods 90000 unpaid blood donors were all subjected to blood type examination and preliminary screening for irregular antibodies. For donors whose preliminary screening results showed positive results and inconsistent ABO positive and negative stereotypes, irregular antibody tests were performed again to identify the class of antibodies [immunoglobulin G(IgG) and immunoglobulin M (IgM)]. The positive detection of irregular antibodies in blood samples of blood donors were analyzed. The positive rates of irregular antibodies in blood donors of different genders and with or without pregnancy history, and the positive rates of irregular antibodies in blood donors of different number of donations and age groups were compared. Results A total of 58 cases (0.06%) of irregular antibody positivity were screened in 90000 blood donors, including 48 cases of specific antibodies, the main types of antibodies were anti-E and anti-M, and the remaining 10 cases were non-specific antibodies, the main types of antibodies were cold autoantibodies. The positive rate of irregular antibodies among 90000 blood donors was 0.10% (45/47011)in females, which was higher than 0.03% (13/42989) in males, and the difference was statistically significant(P<0.05). The positive rate of irregular antibodies among donors with a history of pregnancy was 0.15% (35/24081),which was higher than 0.04% (10/22930) among donors without a history of pregnancy, and the difference was statistically significant (P<0.05). Among 90000 blood donors, the positive rate of irregular antibodies in first-time donors was 0.14% (37/27839), which was higher than 0.04% (21/62161) of donors who had number of donations≥2 times, and the difference was statistically significant (χ^(2)=29.335, P<0.05). There were statistically significant differences in the positive rate of irregular antibodies among blood donors of different age groups (P<0.05), and the older the donors were, the higher the irregular antibody positivity rate was, with up to 52 cases (89.66%) of donors with agglutination intensity ≤++. Conclusion The positive rate of red blood cell irregular antibodies in the blood of unpaid blood donors in Foshan area is low, mainly anti-E, anti-M and cold autoantibodies. Blood stations need to strengthen the screening and identification of red blood cell irregular antibodies.