【摘要】 目的探讨拟输血患者不规则抗体检出情况及危险因素,为促进临床输血安全提供依据。方法回顾性分析本院2012年6月至2018年10月拟输血治疗的8 775例患者的不规则抗体检出率、分布特征及危险因素。结果本组不规则抗体阳性率为0.91%(80/8 775),77例进行了特异性鉴定,除1例为假凝集外,占比最高的Rh血型抗体为28.95%(22/76),其中抗-E占59.09%(13/22);其次为MNS血型抗体19.74%(15/76),其中抗-M占66.67%(10/15);其他为Lewis血型抗体6.58%(5/76),Duffy血型抗体1.32%(1/76),混合抗体15.79%(12/76),自身抗体17.11%(13/76),冷抗体及特异性待定占10.53%(8/76)。单因素分析显示,不规则抗体筛查阳性组与阴性组患者的年龄、输血史、疾病类型存在显著差异(P<0.05),二元Logistic回归分析显示有输血史,消化系统疾病、慢性肾脏疾病、实体肿瘤及血液系统疾病、内科重症疾病是不规则抗体检出的独立危险因素(P<0.05)。结论建议针对有输血史或需要反复长期输血的患者在ABO/RhD基础上增加RhCcEe(至少RhE)相合性输注,同时根据其他抗体特异性选择相应抗原阴性的血液制品输注,将有效防止不规则抗体的产生,促进临床用血安全。更多还原

【Abstract】 Objective To analyze the screening results and risk factors of irregular antibodies in patients receiving blood transfusions,and provide theoretical evidence for promoting safe clinical transfusion.Methods We retrospectively analyzed the detection rate,distribution characteristics and risk factors of irregular antibodies in 8 775 patients who were planned to be transfused from June 2012 to October 2018 in our hospital.Results The positive rate of irregular antibodies in this study was 0.91% (80/8 775),and 77 cases were further identified.Except for 1 case of pseudoagglutination,Rh antibodies most frequently detected was 28.95% (22/76),of which anti-E accounted for 59.09% (13/22).Followed by MNS antibodies 19.74% (15/76),of which anti-M accounted for 66.67% (10/15).Others were Lewis antibodies 6.58% (5/76),Duffy antibodies 1.32% (1/76),multiple antibodies 15.79% (12/76),autoantibodies 17.11% (13/76),cold antibodies and antibodies of undetermined specificity 10.53% (8/76).Univariate analysis showed that there were significant differences in age,history of blood transfusion,and disease types between patients with positive antibody screen and negative group (P<0.05).Binary logistic regression analysis revealed history of blood transfusion,digestive system disease,chronic kidney disease,solid tumor and hematological diseases,severe internal disease were independent risk factors for the detection of irregular antibodies (P<0.05).Conclusion We recommend adding RhCcEe (at least RhE) typing Rh-matched transfusions as well as the standard ABO/RhD match for patient who has a history of blood transfusion or requires long-term support with frequent transfusions,and providing matched antigen-negative blood products for transfusion based on positive for other irregular antibodies in patient.This will effectively prevent patients from producing irregular antibodies and promote blood transfusion safety.更多还原