39 671例输血患者不规则抗体的筛选与鉴定结果分析

刘凯; 吴静; 许珣; 管政; 许力; 张军

doi:10.16766/j.cnki.issn.1674-4152.003644

39 671例输血患者不规则抗体的筛选与鉴定结果分析

doi: 10.16766/j.cnki.issn.1674-4152.003644

蚌埠医科大学第一附属医院输血科，安徽蚌埠 233004

基金项目:

安徽省高校科学研究项目 KJ2020A0561

详细信息

通讯作者:
张军，E-mail: 13909652118@163.com

中图分类号: R457.1 R446.11
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出版历程
- 收稿日期: 2023-11-17
- 网络出版日期: 2024-11-19

Analysis of screening and identification of irregular antibodies in 39 671 blood transfusion patients

Department of Blood Transfusion, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China

摘要

摘要: 目的对输血患者中不规则抗体的筛选与鉴定结果进行分析，以探讨不规则抗体的产生及其特异性分布与性别、输血史、妊娠史的关系。方法从蚌埠医科大学第一附属医院电子病历系统中检索出2021年1月—2022年12月的39 671例输血患者不规则抗体的筛选与鉴定结果，统计不规则抗体阳性病例数，分析不规则抗体的阳性率、特异性与患者性别、输血史、妊娠史的关系。结果 671例输血患者中，不规则抗体筛选阳性者共365例，阳性率为0.92%。其中占比最高的为Rh血型系统抗体(213例，占58.36%)。数据分析显示，365例不规则抗体阳性患者中女性(228例，占62.47%)占比高于男性(137例，占37.53%)，且女性抗筛阳性患者Rh血型系统抗体占比(143例，占62.72%)显著高于男性(70例，占51.09%，P=0.037)，有输血史和有妊娠史的患者更易出现Rh血型系统抗体阳性(P < 0.05)。结论女性、输血史和妊娠史都会增加抗体筛选阳性发生的概率，在对一般输血患者进行不规则抗体筛选和鉴定的同时，应特别加强对女性、有输血史和妊娠史输血患者的检测。
- 不规则抗体 /
- 输血 /
- Rh血型系统
Abstract: Objective To analyze the screening and identification results of irregular antibodies in patients with blood transfusion, and to explore the relationship between irregular antibodies and gender, blood transfusion history, and pregnancy history. Methods The screening and identification results of irregular antibodies in 39 671 transfusion patients from January 2021 to December 2022 were obtained from the hospital electronic medical record system. The number of positive cases for irregular antibodies was recorded, the distribution of irregular antibodies was analyzed, and the relationship between the positive rate and specificity of irregular antibodies and patient gender, transfusion history, and pregnancy history was explored. Results Among the 39 671 transfusion patients, a total of 365 cases tested positive for irregular antibodies, with a positivity rate of 0.92%. Among them, the highest proportion was positive antibodies in the Rh blood type system (213 cases, accounting for 58.36%). The data showed that among the 365 patients with positive irregular antibodies, females (228 cases, 62.47%) had a higher proportion than males (137 cases, 37.53%), and the positivity rate of Rh blood type system antibodies in female patients (143 cases, 62.72%) was significantly higher than that in males (70 cases, 51.09%; P=0.037). Patients with a history of transfusion and those with a history of pregnancy were more likely to have positive Rh blood type system antibodies (P < 0.05). Conclusion Women, blood transfusion history and pregnancy history will increase the probability of positive results on irregular antibody screening. While irregular antibody screening and identification for patients who have conventional transfusion therapy are carried out, the detection for women, patients with blood transfusion history or pregnancy history should be especially strengthened.
- Irregular antibodies /
- Blood transfusion /
- Rh blood group system

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表 1 365例不规则抗体特异性分布

Table 1. Distribution of irregular antibodies in 365 cases

抗体系统	抗体种类	阳性例数	构成比(%)
Rh系统(n=213)	抗-E	89	24.38
	抗-e	7	1.92
	抗-C	9	2.47
	抗-c	18	4.93
	抗-D	49	13.42
	抗-Ce	15	4.11
	抗-CD	8	2.19
	抗-CE	6	1.64
	抗-cE	12	3.29
MNS系统(n=84)	抗-M	68	18.63
MNS系统(n=84)	抗-N	16	4.38
Lewis系统(n=40)	抗-Lea	35	9.59
Lewis系统(n=40)	抗-Leb	5	1.37
Kidd系统(n=18)	抗-JKa	15	4.11
Kidd系统(n=18)	抗-JKb	3	0.82
Duffy系统(n=10)	抗-Fya	4	1.10
Duffy系统(n=10)	抗-Fyb	6	1.64
合计		365	100.00

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表 2 不规则抗体特异性分布与患者特征的相关信息分析[例(%)]

Table 2. Analysis of the correlation between irregular antibodies distribution and patient ' s characteristics [cases (%)]

抗体种类	性别		输血史		妊娠史
抗体种类	男性(n=137)	女性(n=228)	有(n=178)	无(n=187)	有(n=180)	无(n=48)
Rh系统(n=213)
抗-E(n=89)	25(18.25)	64(28.07)	50(28.09)	39(20.86)	52(28.89)	12(25.00)
抗-e(n=7)	3(2.19)	4(1.75)	4(2.25)	3(1.60)	4(2.22)	0
抗-C(n=9)	5(3.65)	4(1.75)	4(2.25)	5(2.67)	4(2.22)	0
抗-c(n=18)	10(7.30)	8(3.51)	8(4.49)	10(5.35)	6(3.33)	2(4.17)
抗-D(n=49)	12(8.76)	37(16.23)	26(14.61)	23(12.30)	35(19.44)	2(4.17)
抗-Ce(n=15)	5(3.65)	10(4.39)	9(5.06)	6(3.21)	7(3.89)	3(6.25)
抗-CD(n=8)	3(2.19)	5(2.19)	5(2.81)	3(1.60)	4(2.22)	1(2.08)
抗-CE(n=6)	2(1.46)	4(1.75)	3(1.69)	3(1.60)	2(1.11)	2(4.17)
抗-cE(n=12)	5(3.65)	7(3.07)	5(2.81)	7(3.74)	5(2.78)	2(4.17)
合计	70(51.09)	143(62.72)	114(64.04)	99(52.94)	119(66.11)	24(50.00)
P值	0.037		0.034		0.045
MNS系统(n=84)
抗-M(n=68)	35(25.55)	33(14.47)	38(21.35)	30(16.04)	28(15.56)	5(10.42)
抗-N(n=16)	4(2.92)	12(5.26)	11(6.18)	5(2.67)	9(5.00)	3(6.25)
合计	39(28.47)	45(19.74)	49(27.53)	35(18.72)	37(20.56)	8(16.67)
P值	0.072		0.048		0.681
Lewis系统(n=40)
抗-Lea(n=35)	10(7.30)	25(10.96)	7(3.93)	28(14.97)	15(8.33)	10(20.83)
抗-Leb(n=5)	1(0.73)	4(1.75)	1(0.56)	4(2.14)	4(2.22)	0
合计	11(8.03)	29(12.72)	8(4.49)	32(17.11)	19(10.55)	10(20.83)
P值	0.225		< 0.001		0.085
Kidd系统(n=18)
抗-JKa(n=15)	8(5.84)	7(3.07)	5(2.81)	10(5.35)	3(1.67)	4(8.33)
抗-JKb(n=3)	2(1.46)	1(0.44)	0	3(1.60)	1(0.56)	0(0.00)
合计	10(7.30)	8(3.51)	5(2.81)	13(6.95)	4(2.22)	4(8.33)
P值	0.134		0.090		0.063
Duffy系统(n=10)
抗-Fya(n=4)	3(2.19)	1(0.44)	0	4(2.14)	0	1(2.08)
抗-Fyb(n=6)	4(2.92)	2(0.88)	2(1.12)	4(2.14)	1(0.56)	1(2.08)
合计	7(5.11)	3(1.32)	2(1.12)	8(4.28)	1(0.56)	2(4.17)
P值	0.186		0.106		0.113
注：比较均采用Fisher精确检验。

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