头孢类抗生素致敏红细胞检测与溶血性贫血的关系

Analysis of the Relationship between Cephalosporin Antibiotic Sensitized Red Blood Cell Detection and Hemolytic Anemia

【目的】探讨头孢类抗生素致敏红细胞检测与溶血性贫血的关系。【方法】收集在本院住院的996例患者(选择做血型检测及准备输血)的血液标本,使用抗球蛋白卡式法检测药物致敏的红细胞直接抗球蛋白试验(DAT)阳性情况,统计临床DAT检测结果及患者在临床中的科室分布。采用抗球蛋白卡式法对DAT阳性血液标本进行抗体分型,DAT阳性强度分布及分类、头孢类抗生素致敏红细胞检测,了解DAT阳性使用抗生素种类。观察患者是否发生溶血性贫血,分析头孢类抗生素致敏红细胞检测与溶血性贫血的关系。【结果】DAT阳性检出率为7.83%(78/996),其中内科患者DAT阳性率高于外科(P<0.05)。78例DAT阳性患者血液标本在抗球蛋白卡中的反应强度为1+、2+、3+、4+的占比分别为28.21%、24.36%、25.64%、21.79%,反应强度分布比较,差异无统计学意义(P>0.05)。DAT阳性分类中抗IgG、抗C3d、抗IgG+C3d占比分别为39.74%、33.33%、26.92%,DAT阳性分类构成比较,差异无统计学意义(P>0.05)。78例DAT阳性患者血液标本中,共检测出4种抗生素致敏红细胞9例,其中头孢克洛致敏红细胞占比均高于头孢哌酮舒巴坦钠、头孢吡肟、头孢他啶(P<0.05),其余抗生素种类间比较,差异均无统计学意义(P>0.05)。DAT阳性患者血液标本中,使用抗生素患者临床溶血性贫血发生率高于未使用抗生素者(P<0.05),使用抗生素致敏红细胞者溶血性贫血发生率高于抗生素未致敏者(P<0.05)。使用抗生素未致敏患者溶血性贫血发生率与未使用抗生素者比较,差异无统计学意义(P>0.05)。【结论】头孢类抗生素致敏红细胞检测与溶血性贫血存在一定的相关性。

【Objective】To explore the relationship between cephalosporin antibioticsensitized red blood cell detection and hemolytic anemia.【Methods】Blood samples of 996 patients who were hospitalized in our hospital for blood type testing and blood transfusion preparation were collected in the study.Antiglobulin cassette method was used to detect drug-sensitized red blood cells for direct antiglobulin test(DAT)positive status.Statistics of clinical DAT test results with patients'distribution in clinical departments was analyzed.Anti-globulin cassette method was used for antibody typing of DAT positive blood samples,DAT positive intensity distribution,classification,cephalosporin antibiotic sensitized red blood cell detection,and DAT positive antibiotic types.The relationship between cephalosporin antibiotic sensitized red blood cell detection and hemolytic anemia was analyzed by clinically investigating whether patients had hemolytic anemia.The blood group automatic analyzer was used to detect the positive status of the drug-sensitized red blood cell direct antiglobulin test(DAT)and the clinical DAT test results were counted.【Results】The positive detection rate of DAT was 7.83%,and the positive rate of DAT in internal medical department was higher than that in surgical department(P<0.05).The reaction intensities(1+,2+,3+and 4+)of the blood samples of 78 DAT positive patients in the antiglobulin card accounted for 28.21%,24.36%,25.64%,and 21.79%,respectively.While there was no statistical difference in the distribution of the reaction intensity(P>0.05).The proportions of anti-IgG,anti-C3d,and anti-IgG+C3d in DAT positive classification were 39.74%,33.33%,and 26.92%,respectively.However,there was no significant difference in the composition of DAT positive classification(P>0.05).In the blood samples of 78 DAT positive patients in this study,a total of 9 cases of erythrocytes sensitized to 4 antibiotics were detected;And the proportion of erythrocytes sensitized to cefaclor was higher than that of cefoperazone-sulbactam sodium,cefepime,ceftazidime(P<0.05).There was no significant difference among the other antibiotics(P>0.05).In the blood samples of DAT positive patients in this study,the incidence of clinical hemolytic anemia in antibiotics users was higher than that of no antibiotics users(P<0.05);And the incidence of hemolytic anemia in antibiotics sensitized red blood cells was higher than that of antibiotic unsensitized patients(P<0.05).There was not statistically significant in the incidence of hemolytic anemia between non-sensitized patients who used antibiotics and those who did not use antibiotics(P>0.05).【Conclusion】There is a certain correlation between cephalosporin antibiotic sensitized red blood cell detection and hemolytic anemia.