9013例输血者不规则抗体筛查结果及意义

摘要

目的 分析9 013例输血者不规则抗体筛查结果,并探讨不规则抗体筛查的临床意义.方法 回顾性分析自2013年7月至2016年8月于首都医科大学附属北京朝阳医院接受输血的病人9 013例,应用微柱凝胶技术筛查不规则抗体,并进行鉴定.统计分析不规则抗体的阳性率、分布及不同科室中不规则抗体的阳性率,另外分析性别及输血/妊娠史对不规则抗体阳性率的影响.结果 9 013例输血者的血液标本中不规则抗体的阳性率为0.63％ (57/9 013),主要为Rh型,占42.11％ (24/57);其次为MNS型,占24.56％(14/57);其他类型及所占比例分别为Lewis系统(10.53％)、Kidd系统(8.77％).P系统(5.26％)及其他(8.77％).外科输血者不规则抗体检出率为1.06％(14/1 321),高于其他科室的0.59％ (43/7 692),差异具有统计学意义(P＜0.05).女性输血者中不规则抗体的阳性率为0.94％ (30/3 187),明显高于男性病人的0.46％ (27/5 826),且差异具有统计学意义(P＜0.05).有输血/妊娠史输血者的血浆中不规则抗体的阳性率为0.85％ (34/3 986),显著高于无输血/妊娠史输血者的0.46％(23/5 027)(P＜0.05).结论 输血前对不规则抗体进行筛查对于提高输血安全性具有重要意义,为筛查呈阳性病人提供适合的血型,从而降低临床免疫溶血事件的发生,提高输血的有效性.%Objective To analyze screening results of 9 013 cases of transfusion irregular antibody,and to explore the clinical significance of the irregular antibody screening.Methods Totally 9 013 cases of patients underwent blood transfusion from July 2013 to August 2016 in Beijing Chaoyang Hospital,Capital Medical University were analyzed retrospectively.The irregular antibody screening and identification were applied with micro-column gel technology.The positive rate of irregular antibody,distribution and irregular antibody positive rate in the different departments were analyzed statistically.In addition,the influence of gender and blood transfusion/history of pregnancy on irregular antibody positive rate.Results The irregular antibody positive rate of 9 013 cases of transfusion of blood specimen was 0.63％ (57/9 013),in which mainly for the Rh,was accounted for 42.11％ (24/57);Second of MNS type,which was accounting for 24.56％ (14/57);Other type and proportion were Lewis system (10.53％),Kidd system (8.77％),P (5.26％) and other (8.77％),respectively.The irregular antibody rate in surgery department was 1.06％ (14/1 321),significandy higher than other department 0.59％ (43/7 692),with significant difference (P ＜ 0.05).The irregular antibody positive rate of women transfusion was 0.94％ (30/3 187),which was significantly higher than the 0.46％ of male patients (27/5 826),and the difference was statistically significant (P ＜ 0.05).The irregular antibody positive rate of patients with blood transfusion/pregnancy history was 0.85％ (34/3 986),which was siguificandy higher than that with no history of transfusion blood transfusion/pregnancy [0.46％ (23/5 027)] (P ＜ 0.05).Conclusion The irregular antibody screening before blood transfusion is of great significance for the improvement of blood transfusion safety,which provides suitable for screening patients with positive blood type.It can reduce clinical immune hemolysis events in order to increase the effectiveness of blood transfusion.