新建医院患者ABO血型表型与不规则抗体结果的分析及其应用
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摘要
目的掌握新建综合医院患者血型表型及不规则抗体的结果并探讨其应用。方法回顾统计该院2016年3月至2018年2月患者ABO、RhD血型表型结果、红细胞悬液使用情况、不规则抗体筛查、部分抗体鉴定结果。结果 ABO血型表型总分布频率特征与红细胞悬液使用比例特征均为O>A>B>AB;RhD阴性频率为0.4%,以妇产科患者所占比例最高;ABO血型在不同性别及RhD阴性、阳性分布中的差异均无统计学意义(P>0.05)。4 032例标本中不规则抗体筛查阳性率为0.7%(29/4 032);女性阳性率(0.8%,22/2 590)虽高于男性阳性率(0.5%,7/1 442),但差异无统计学意义(P>0.05);有妊娠史病例阳性率(0.9%,20/2 251)高于无妊娠史(0.5%,9/1 781),但差异无统计学意义(P>0.05);有输血史病例阳性率(3.6%,12/326)高于无输血史病例阳性率(0.5%,17/3 706),差异有统计学意义(P<0.05);既有输血史也有妊娠史的病例阳性率(4.5%,5/112)高于其他患者(0.6%,24/3 920),差异有统计学意义(P<0.05)。6例经鉴定为自身抗体2例,抗M抗体2例,抗Fya、抗Jka各1例。结论该新建医院可参考患者血型表型分布特征来制订、动态调整血液贮存计划,且需不断提升实验室筛查与鉴定不规则抗体能力来确保输血安全、有效。
Objective To study the results of blood type phenotypes and irregular antibody screening for patients in newly built general hospital,and to discuss the application.Methods From March 2016 to February 2018,the results of ABO,RhD blood type phenotypes,the application of red cells suspension,the results of irregular antibody screening and the partial results of antibody identification in our hospital were retrospectively analyzed.Results Consistently,both of the frequency distribution of ABO blood type phenotypes and the proportion of the used total red cells suspension were O>A>B>AB.RhD negative frequency was 0.4%,and the proportion of obstetrics and gynecology patients was the highest.There was no significant difference in ABO blood group between different genders and the distribution of RhD negative and positive(P>0.05).The positive rate of irregular antibody screening in 4 032 samples was 0.7%(29/4 032);the positive rate in women(0.8%,22/2 590)was higher than that in men(0.5%,7/1 442),but there was no significant difference(P>0.05);the positive rate in cases with pregnancy history(0.9%,20/2 251)was higher than that in cases without pregnancy history(0.5%,9/1 781),but there was no significant difference(P>0.05).The positive rate of cases with blood transfusion history(3.6%,12/326)was higher than that without blood transfusion history(0.5%,17/3 706),the difference was statistically significant(P<0.05);the positive rate of cases with both blood transfusion history and pregnancy history(4.5%,5/112)was higher than that of other patients(0.6%,24/3 920),the difference was statistically significant(P<0.05).Six cases were identified as autoantibodies in 2 cases,anti-M antibodies in 2 cases,anti-Fya and anti-Jka in 1 case respectively.ConclusionThe new hospital can draw up and dynamically adjust the blood storage plan by referring to the characteristics of blood phenotype distribution.It also needs to constantly improve the ability of laboratory screening and identification of irregular antibodies to ensure the safety and effectiveness of blood transfusion.
Objective To study the results of blood type phenotypes and irregular antibody screening for patients in newly built general hospital,and to discuss the application.Methods From March 2016 to February 2018,the results of ABO,RhD blood type phenotypes,the application of red cells suspension,the results of irregular antibody screening and the partial results of antibody identification in our hospital were retrospectively analyzed.Results Consistently,both of the frequency distribution of ABO blood type phenotypes and the proportion of the used total red cells suspension were O>A>B>AB.RhD negative frequency was 0.4%,and the proportion of obstetrics and gynecology patients was the highest.There was no significant difference in ABO blood group between different genders and the distribution of RhD negative and positive(P>0.05).The positive rate of irregular antibody screening in 4 032 samples was 0.7%(29/4 032);the positive rate in women(0.8%,22/2 590)was higher than that in men(0.5%,7/1 442),but there was no significant difference(P>0.05);the positive rate in cases with pregnancy history(0.9%,20/2 251)was higher than that in cases without pregnancy history(0.5%,9/1 781),but there was no significant difference(P>0.05).The positive rate of cases with blood transfusion history(3.6%,12/326)was higher than that without blood transfusion history(0.5%,17/3 706),the difference was statistically significant(P<0.05);the positive rate of cases with both blood transfusion history and pregnancy history(4.5%,5/112)was higher than that of other patients(0.6%,24/3 920),the difference was statistically significant(P<0.05).Six cases were identified as autoantibodies in 2 cases,anti-M antibodies in 2 cases,anti-Fya and anti-Jka in 1 case respectively.ConclusionThe new hospital can draw up and dynamically adjust the blood storage plan by referring to the characteristics of blood phenotype distribution.It also needs to constantly improve the ability of laboratory screening and identification of irregular antibodies to ensure the safety and effectiveness of blood transfusion.
引文
[1]张印则,徐华,周华友.红细胞血型原理与检测策略[M].北京:人民卫生出版社,2014.
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[3]王静,徐凤娟,叶宏辉,等.金华市9 930例住院患者ABO与Rh血型调查分析[J].临床血液学杂志(输血与检验),2012,14(6):770-771.
[4]吴敏华,杜超华.某三甲综合医院近9年临床用血的回顾性分析[J].临床输血与检验,2013,15(4):346-348.
[5]陈才生.ABO、Rh(D)血型分布及质量分析[J].国际检验医学杂志,2010,31(1):77-78.
[6]林淼雄,顾向明,彭明,等.中山地区住院患者RhD阴性血型分布特点与输血安全的临床研究[J].中国现代医生,2017,11(34):88-90.
[7]中国医师协会输血科医师分会,中华医学会临床输血学分会.特殊情况紧急抢救输血推荐方案[J].中国输血杂志,2014,27(1):1-3.
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[9]向东.关于不规则抗体检测[J].中国输血杂志,2016,29(11):1219.
[10]郑妍,王文婷,穆士杰.血型不规则抗体阳性患者的管理[J].国际检验医学杂志,2018,39(1):125-127.
[11]邓超干,罗钦泉,陆冰露,等.5 628例预输血患者不规则抗体筛查结果分析[J].实验与检验医学,2017,35(5):814-816.
[12]杨秀华,杨惠宽,黄建云,等.不规则抗体筛查分布及其临床意义[J].中国输血杂志,2014,27(9):899-902.
[13]TORMEY C A,FISK J,STACK G.Red blood cell alloantibody frequency,specificity,and properties in a population of male military veterans[J].Transfusion,2008,48(10):2069-2076.
[14]赵颖欣,王德辉,柴慧丽,等.血型不规则抗体筛查用于预防和降低临床无效输血的发生[J].中国输血杂志,2015,28(1):48-50.
[15]陈洪国,谭廷爵.8 775例临床输血治疗患者不规则抗体筛查结果分析[J].国际检验医学杂志,2012,33(4):444-445.
[16]郑楚忠,唐万兵,郑望春,等.深圳地区无偿献血者不规则抗体筛查结果分析[J].国际检验医学杂志,2015,36(12):1693-1694.
[17]王谦,燕备战,于洋.31 766名患者红细胞血型不规则抗体分析[J].中国输血杂志,2011,24(11):966-968.
[2]王钰箐,蔡晓红,龚淞颂,等.46 346名患者不规则抗体筛查结果及分析[J].中国输血杂志,2015,28(8):1004-1006.
[3]王静,徐凤娟,叶宏辉,等.金华市9 930例住院患者ABO与Rh血型调查分析[J].临床血液学杂志(输血与检验),2012,14(6):770-771.
[4]吴敏华,杜超华.某三甲综合医院近9年临床用血的回顾性分析[J].临床输血与检验,2013,15(4):346-348.
[5]陈才生.ABO、Rh(D)血型分布及质量分析[J].国际检验医学杂志,2010,31(1):77-78.
[6]林淼雄,顾向明,彭明,等.中山地区住院患者RhD阴性血型分布特点与输血安全的临床研究[J].中国现代医生,2017,11(34):88-90.
[7]中国医师协会输血科医师分会,中华医学会临床输血学分会.特殊情况紧急抢救输血推荐方案[J].中国输血杂志,2014,27(1):1-3.
[8]GARG N,SHARMA T,SINGH B.Prevalence of irregular red blood cell antibodies among healthy blood donors in Delhi population[J].Transfus Apher Sci,2014,50(3):415-417.
[9]向东.关于不规则抗体检测[J].中国输血杂志,2016,29(11):1219.
[10]郑妍,王文婷,穆士杰.血型不规则抗体阳性患者的管理[J].国际检验医学杂志,2018,39(1):125-127.
[11]邓超干,罗钦泉,陆冰露,等.5 628例预输血患者不规则抗体筛查结果分析[J].实验与检验医学,2017,35(5):814-816.
[12]杨秀华,杨惠宽,黄建云,等.不规则抗体筛查分布及其临床意义[J].中国输血杂志,2014,27(9):899-902.
[13]TORMEY C A,FISK J,STACK G.Red blood cell alloantibody frequency,specificity,and properties in a population of male military veterans[J].Transfusion,2008,48(10):2069-2076.
[14]赵颖欣,王德辉,柴慧丽,等.血型不规则抗体筛查用于预防和降低临床无效输血的发生[J].中国输血杂志,2015,28(1):48-50.
[15]陈洪国,谭廷爵.8 775例临床输血治疗患者不规则抗体筛查结果分析[J].国际检验医学杂志,2012,33(4):444-445.
[16]郑楚忠,唐万兵,郑望春,等.深圳地区无偿献血者不规则抗体筛查结果分析[J].国际检验医学杂志,2015,36(12):1693-1694.
[17]王谦,燕备战,于洋.31 766名患者红细胞血型不规则抗体分析[J].中国输血杂志,2011,24(11):966-968.