住院拟输血患者不规则抗体的鉴定与分析

Identification and Analysis of Irregular Antibodiesin Hospitalized Patients Prepared to Accept Blood Transfusion

目的:分析71847例拟输血患者不规则抗体的类型和分布特点,探究其对临床安全输血的作用。方法:选取本院2020年1月到2023年10月期间71847例拟输血患者的血液标本,采用微柱凝胶检测卡进行不规则抗体筛查及抗体鉴定。结果:71847例拟输血患者中,共筛选出不规则抗体阳性301例(0.42%),包括同种抗体252例(83.72%);其中Rh系统最高,为179例(59.47%)。Rh系统抗体包括抗E 135例(44.85%)、抗E+c 24例(7.97%)、抗C+e 10例(3.32%)、抗c 6例(1.99%)、抗D 3例(1.00%)和抗D+C 1例(0.33%)。通过对301例不规则抗体进行分析发现,>60岁组的阳性率高于≤60岁组(0.61%vs 0.33%),女性组的阳性率高于男性组(0.50%vs 0.31%),内科组(1.25%)和妇产科组(0.32%)的阳性率均高于外科(0.20%),妊娠/输血史组的阳性率高于无妊娠/输血史组(0.64%vs 0.13%),差异均具有统计学意义(P<0.05)。结论:有必要将RhE纳入血型常规监测,并在输血时尽可能地进行E抗原匹配,这可以很大程度地降低不规则抗体的阳性率,从而达到更安全的输血治疗。

Objective:To analyze the type and distribution characteristics of irregular antibodies in 71847 hospitalized patients who prepared to accept blood transfusion,and to explore their role in safe blood transfusion.Methods:71847 patients who applied for red blood transfusion from January 2020 to October 2023 were selected.All specimens were screened and identified for the irregular antibody by microcolumn gel antiglobulin technique.Results:Among the 71847 patients preparing for accept blood transfusion,301 cases tested positive for irregular antibodies(0.42%).Of these 301 antibody-positive patients,252(83.72%)exhibited alloantibodies.The Rh blood group system was the most common,accounting for 179 cases(59.47%).Antibodies in Rh blood group system included anti-E(135,44.85%),anti-E+c(24,7.97%),anti-C+e(10,3.32%),anti-c(6,1.99%),anti-D(3,1.00%),and anti-D+C(1,0.33%).By analyzing 301 cases with irregular antibodies,it found the positive rate of>60 years old group was higher than that in≤60 years old(0.61%vs 0.33%),female group was higher than that in male group(0.50%vs 0.31%),internal medicine and gynaecology and obstetrics groups were both higher than that in surgery group(1.25%vs 0.20%;0.32%vs 0.20%),group with pregnancy/transfusion history was higher than that in non-pregnancy/transfusion history(0.64%vs 0.13%),the differences were statistically significant(P<0.05).Conclusion:In the routine monitoring of the blood group,it is necessary to detect RhE,so as to reduce the positive rate of irregular antibodies greatly and further ensure the safety of blood transfusion.