红细胞血型不规则抗体筛检试验结果分析和临床应用价值
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摘要
目的:分析广东省英德地区人群红细胞血型不规则抗体筛检试验的结果分布规律,探讨不规则抗体筛检试验在临床输血治疗中的应用价值。方法:选取2016～2017年英德市人民医院行输血治疗前拟定需做红细胞血型不规则抗体筛检患者3 370例为本次试验样本人群,采用抗人球蛋白检测卡微柱凝胶法检测,统计分析不同性别患者红细胞不规则抗体检出情况、既往输血和(或)妊娠史对红细胞不规则抗体检出情况的影响,并分析12例红细胞不规则抗体特异性分布。结果:从3 370例样本做不规则抗体筛检试验中,共筛检出不规则抗体阳性12例(占0. 23%),其中男4例,女8例,1例因不规则抗体阳性导致主、次侧交叉配不相合放弃输血。男性患者红细胞不规则抗体检出率0. 22%(4/1792)显著低于女性0. 51%(8/1 578)(P <0. 05),未检出率99. 78%(1 788/1 792)显著高于女性99. 49%(1 570/1 578)(P <0. 05)。既往输血和(或)妊娠史患者的红细胞不规则抗体检出率0. 65%(9/1 388)显著高于既往无输血和(或)妊娠史患者的0. 15%(3/1 982)(P <0. 05),未检出率99. 35%(1 379/1 388)显著低于既往无输血和(或)妊娠史患者的99. 85%(1 979/1 982)(P <0. 05)。结论:红细胞血型不规则抗体女性多于男性,输血治疗做红细胞血型不规则抗体筛检试验可提高临床输血质量,安全、有效,同时减少输血不良反应。
Objective To analyze the distribution of the results of irregular antibody screening test for erythrocyte blood group in Yingde area,and to explore the application value of irregular antibody screening test in clinical blood transfusion treatment.Method A total of 3 370 patients who were screened for irregular red blood cell antibodies from Yingde people's Hospital from 2016 ～ 2017 years ago were collected. The samples were tested by anti human globulin test card microcolumn gel method,and then the situation of irregular antibody detection in different sex patients was statistically analyzed. The influence of previous blood transfusion/pregnancy history on the detection of irregular antibodies to erythrocyte and the specific distribution of irregular antibodies to erythrocyte in 12 cases were analyzed. Results Among 3 370 samples, 12( 0. 23%) were positive for irregular antibodies,including 4 males and 8 females, and 1 gave up blood transfusion due to irregular antibody positive. The detection rate of irregular red blood cell antibodies in male patients was 0. 22%( 4/1 792) significantly lower than that in female patients 0. 51%( 8/1 578)( P < 0. 05),while the non-detection rate was 99. 78%( 1 788/1 792) significantly higher than that in female patients99. 49%( 1 570/1 578)( P < 0. 05). The detection rate of RBC irregular antibodies in patients with previous blood transfusion/pregnancy history was 0. 65%( 9/1 388) significantly higher than that in patients without previous blood transfusion/pregnancy history 0. 15%( 3/1 982)( P < 0. 05), and the non-detection rate was 99. 35%( 1 379/1 388) significantly lower than that in patients without previous blood transfusion/pregnancy history 99. 85%( 1 979/1 982)( P < 0. 05). Conclusion Irregular antibodies of erythrocyte blood group are more common in females than in males. Screening test for irregular antibodies of erythrocyte blood group can improve the quality of clinical blood transfusion and reduce adverse reactions of blood transfusion.
Objective To analyze the distribution of the results of irregular antibody screening test for erythrocyte blood group in Yingde area,and to explore the application value of irregular antibody screening test in clinical blood transfusion treatment.Method A total of 3 370 patients who were screened for irregular red blood cell antibodies from Yingde people's Hospital from 2016 ～ 2017 years ago were collected. The samples were tested by anti human globulin test card microcolumn gel method,and then the situation of irregular antibody detection in different sex patients was statistically analyzed. The influence of previous blood transfusion/pregnancy history on the detection of irregular antibodies to erythrocyte and the specific distribution of irregular antibodies to erythrocyte in 12 cases were analyzed. Results Among 3 370 samples, 12( 0. 23%) were positive for irregular antibodies,including 4 males and 8 females, and 1 gave up blood transfusion due to irregular antibody positive. The detection rate of irregular red blood cell antibodies in male patients was 0. 22%( 4/1 792) significantly lower than that in female patients 0. 51%( 8/1 578)( P < 0. 05),while the non-detection rate was 99. 78%( 1 788/1 792) significantly higher than that in female patients99. 49%( 1 570/1 578)( P < 0. 05). The detection rate of RBC irregular antibodies in patients with previous blood transfusion/pregnancy history was 0. 65%( 9/1 388) significantly higher than that in patients without previous blood transfusion/pregnancy history 0. 15%( 3/1 982)( P < 0. 05), and the non-detection rate was 99. 35%( 1 379/1 388) significantly lower than that in patients without previous blood transfusion/pregnancy history 99. 85%( 1 979/1 982)( P < 0. 05). Conclusion Irregular antibodies of erythrocyte blood group are more common in females than in males. Screening test for irregular antibodies of erythrocyte blood group can improve the quality of clinical blood transfusion and reduce adverse reactions of blood transfusion.
引文
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[5]王晓宁,赵震,刘冰,等.临床待输血患者Rh E抗原和不规则抗体的检测及其临床意义[J].吉林大学学报(医学版),2018,44(4):801.
[6] Ramis G,Martínez-Alarcón L,Majado M,et al. Irregularxenoantibodies against human red blood cells in Papio anubis,Pursinus,P hamadryas,P papio,Saimiri sciureus,and Macaca mu-latta:possible effect on xenotransplantation results[J]. TransplantProc,2010,42(1):387.
[7] Nadarajan VS,Laing AA,Saad SM,et al. Prevalence andspecificity of red-blood-cell antibodies in a multiethnic Southand East Asian patient population and influence of using novelMUT+Mur+kodecytes on its detection[J]. Vox Sang,2012,102(1):65.
[2]吴昌松,朱廷伦,罗志月,等. Jk(a+b-)产生抗-Jk~b导致急性溶血输血不良反应1例[J].中国输血杂志,2016,29(5):315.
[3]杜娟,张勇萍,杨世明,等. 265例血型不规则抗体特异性及其临床分布情况的分析[J].国际检验医学杂志,2016,37(7):956.
[4]周安祥,王思丽,张默吟,等.微柱凝胶卡式血型鉴定的干扰因素分析及处理[J].吉林医学,2012,33(23):5044.
[5]王晓宁,赵震,刘冰,等.临床待输血患者Rh E抗原和不规则抗体的检测及其临床意义[J].吉林大学学报(医学版),2018,44(4):801.
[6] Ramis G,Martínez-Alarcón L,Majado M,et al. Irregularxenoantibodies against human red blood cells in Papio anubis,Pursinus,P hamadryas,P papio,Saimiri sciureus,and Macaca mu-latta:possible effect on xenotransplantation results[J]. TransplantProc,2010,42(1):387.
[7] Nadarajan VS,Laing AA,Saad SM,et al. Prevalence andspecificity of red-blood-cell antibodies in a multiethnic Southand East Asian patient population and influence of using novelMUT+Mur+kodecytes on its detection[J]. Vox Sang,2012,102(1):65.