输血前不规则抗体检测对输血安全性的影响分析

Analysis of the Influence of Irregular Antibody Detection on Blood Transfusion Safety Before Blood Transfusion

目的探讨分析输血前不规则抗体检测(irregular antibodies detection,IAD)对患者输血安全性的影响。方法收集本院2019年1月—2020年1月的需接受输血的患者4202例为研究对象,将其随机分为对照组(n=2100)和试验组(n=2102)。对照组输血前行一般常规检测,但不进行IAD。试验组在常规检测基础上,采用微柱凝胶抗人球蛋白法进行IAD,阳性患者进一步采用谱细胞进行抗体特异性鉴定。分析并比较两组患者输血后不良反应发生率。分析不规则抗体检出情况和患者特征。结果试验组输血后不良反应发生率低于对照组(0.43%vs.1.43%,P=0.003),差异有统计学意义(P<0.05),其中发热反应最常见。不规则抗体检出率为1.24%(26/2102),其中Rh血型系统抗体最多见,占比42.31%(11/26);检出不规则抗体的标本最多来源于内科,占比26.92%(7/26)。检出不规则抗体的患者中有输血史(19.23%vs.7.76%,P=0.031)、妊娠史(63.64%vs.23.87%,P=0.010)的比例高于未检出者,差异有统计学意义(P<0.05)。结论IAD对于安全输血和减少受血者输血反应至关重要。IAD是对ABO血液鉴定的补充,建议将IAD作为输血前基本检测方案的一部分,特别是针对有输血史和妊娠史的患者。

Objective To explore the impact of irregular antibody detection(IAD)on blood transfusion safety before blood transfusion.Methods A total of 4202 patients who needed to receive blood transfusion from January 2019 to January 2020 in our hospital were collected as research subjects,and randomly divided into control group(n=2100)and experimental group(n=2102).The control group underwent general routine testing before blood transfusion,but no IAD.Based on routine testing,the experimental group were tested for IAD by microcolumn gel anti-human globulin method,and positive patients were further identified with spectrum cells for antibody specificity.The incidence of adverse reactions after blood transfusion was analyzed and compared between the two groups.Results of irregular antibody detection and patient characteristics were analyzed.Results The incidence of adverse reactions after blood transfusion in the experimental group was lower than that in the control group(0.43%vs.1.40%,P=0.003),the difference was statistically significant(P<0.05),and fever reactions were the most common transfusion reaction.The detection rate of irregular antibodies was 1.24%(26/2102),of which Rh blood group system antibodies were the most common,accounting for42.31%(11/26);specimens with irre gular antibo dies detected were most from Internal Medicine Department,accounting for26.92%(7/26).The proportion of patients with irregular antibodies detected had a history of blood transfusion(19.23%vs.7.76%,P=0.031)and pregnancy history(63.64%vs.23.87%,P=0.010),which were higher than those without detection,and the differences were statistically significant significance(P<0.05).Conclusion IAD is essential for safe blood transfusion and reducing blood transfusion reaction.IAD is a supplement to the blood identification of ABO.It is recommended to use IAD as part of the basic pre-transfusion testing program,especially for patients with a history of blood transfusion and pre gnancy.