盐城地区不规则抗体或直抗阳性医院退血的研究分析

Study and analysis due to blood return from hospital with positive test results of irregular antibody positive or DAT in Y ancheng area

目的:探讨降低盐城地区因不规则抗体和直接抗人球蛋白试验阳性血液制品报废率的有效策略,提高临床输血安全。方法:分析盐城地区2019年1月-2022年12月期间因不规则抗体阳性或直抗阳性医院退血情况,对退血进行不规则抗体或直抗检测,并且结合无偿献血者资料,进行研究分析。结果:因不规则抗体阳性或直抗阳性原因由医院退回血站的血液制品共221例,经确认,不规则抗体阳性117例,直抗阳性74例,不规则抗体且直抗同时阳性4例;对不规则抗体阳性标本进行分型鉴定,MN系统占比最高38.02%(46/121);女性的不规则抗体阳性和直抗阳性率均高于男性,差异有统计学意义(P<0.05);ABO系统中四种血型不规则抗体阳性率差异有统计学意义(P<0.05),而直抗阳性率差异无统计学意义(P>0.05);比较不同月份,冬季不规则抗体阳性率高于夏季,而夏季的直抗阳性率高于冬季。结论:为降低因不规则抗体和直抗阳性血液制品报废率,提高临床输血有效率,首先应做好精准性的献血者招募,其次在无偿献血人群中开展不规则抗体和直抗筛查。

Objective:To explore the effective strategies to reduce the scrap rate of blood products due to positive irregular antibodies and direct anti-human globulin tests in Yancheng area,and improve the safety of clinical blood transfusion.Methods:Analyze the situation of hospital blood withdrawal due to irregular antibody positive or direct antibody positive cases in Yancheng area from January 2019 to December 2022.Conduct irregular antibody or direct antibody testing for blood withdrawal,and combine data from unpaid blood donors for research and analysis.Results:A total of 221 blood products returned to our station by the hospital due to positive irregular antibodies or direct antibodies.After confirmation,117 cases were positive for irregular antibodies,74 cases were positive for direct antibodies,and 4 cases were both;The MN system accounted for the highest proportion of 38.02%(46/121),in irregular antibody positive samples.The positive rates of rregular antibodies and direct antibodies in women were higher than those in men,with a statistically significant difference(P<0.05);In the ABO system blood types,there was a statistically significant difference in the positive rates of irregular antibodies among the four blood types(P<0.05),while there was nothing in the positive rates of direct antibodies(P>0.05).Comparing different months,the positive rate of irregular antibodies in winter is higher than that in summer,while the positive rate of direct antibodies in summer is higher than that in winter.Conclusion:To reduce the scrap rate of irregular antibodies and direct antibody positive blood products in our station and improve the efficiency of clinical blood transfusion,we should first recruit accurate blood donors,and then conduct irregular antibody and direct antibody screening among the unpaid blood donors.