不规则抗体体内消减速率的研究

发布时间：2018-04-15 20:49

本文选题：不规则抗体 + 抗体消减　；参考：《中国输血杂志》2016年11期

【摘要】：目的通过回顾性研究红细胞血型不规则抗体在体内的消减,比较不同特异性不规则抗体的体内消减速率,探讨其特点,为输血相关不规则抗体检测提供参考和数据。方法研究2000-2016年上海地区存在不规则抗体的患者案例(不包括冷抗体,自身抗体和产前检查中发现的不规则抗体)。选择不同时间多次检测的患者,研究其输血史和不规则抗体强度变化,在考虑可比性的前提下,计算各类不规则抗体消减速率。根据不规则抗体检测中的凝集强度为抗体赋值(赋值方法参照AABB),结合检测间隔天数计算不规则抗体消减速率。结果共有110例不规则抗体具有多次检测的可比性数据(抗体特异性包括抗-E/-Ec,抗-Ce/-C,抗-D,抗-Jka,抗-Jkb,抗-Fyb,抗-Dia,抗-Wra,抗-M,抗-S),其中10%的不规则抗体在多次检测中逐渐消减至无法测得。Rh血型系统抗体在体内30 d(下同)平均消减速率0.259/30 d。非Rh血型系统抗体在体内平均消减速率:1.08/30 d。结论不同个体不规则抗体体内平均消减速率差异很大,Rh血型系统不规则抗体在体内平均消减速率低于其它血型系统抗体,由于其消减可能导致输血前检测的漏检和溶血性输血反应,临床输血应该重视对患者以往输血史、妊娠史,特别是以往不规则抗体检出史的了解。
[Abstract]:Objective to study retrospectively the subtractive rate of irregular antibodies against erythrocyte blood group in vivo, compare the subtractive rates of different specific irregular antibodies, and explore the characteristics of irregular antibodies, so as to provide reference and data for the detection of irregular antibodies related to blood transfusion.Methods patients with irregular antibodies in Shanghai from 2000 to 2016 (excluding cold antibodies, autoantibodies and irregular antibodies found in prenatal examination) were studied.The blood transfusion history and irregular antibody intensity changes were studied in patients with multiple tests at different times. The subtractive rates of irregular antibodies were calculated on the premise of comparability.According to the agglutination intensity in the detection of irregular antibodies, the antibody was assigned (the method of assignment referred to AABBX, and the irregular antibody subtractive rate was calculated by combining with the days of detection interval).Results there were 110 irregular antibodies with comparable data (the specific antibodies included anti--E / -Ec-E, anti-Ce-r-C, anti--D-, anti--Jka, anti--Jkb, anti--Fyb, anti-Dia-, anti--Wra, anti--M-, anti--She), of which 10% of the irregular antibodies were gradually subtracted during multiple tests.The average rate of reduction of the antibody against the. Rh blood group system in vivo was 0. 259 / 30 days after 30 days (the same below).The average subtractive rate of non-Rh blood group antibodies in vivo was 1. 08 / 30 days.Conclusion the average subtractive rate of irregular antibodies in different individuals is significantly lower than that of other blood group system antibodies in vivo.Since the subtraction may lead to missed detection and hemolytic transfusion reaction before blood transfusion, clinical blood transfusion should pay attention to the understanding of patients' history of blood transfusion, pregnancy history, especially the history of irregular antibody detection in the past.
【作者单位】：上海市血液中心;
【基金】：上海市输血医学学科建设项目(编号:15GWZK0501)
【分类号】：R457.1

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