ABO血型系统以外的抗体与安全输血
发布时间：2019-05-08 11:40
【摘要】：目的:筛查某地区ABO血型系统以外的不规则抗体阳性情况,并对不规则抗体进行分型鉴定。研究性别、输血史、妊娠史与抗体检出的关系,掌握人群中ABO血型系统以外的不规则抗体的阳性发生率及类型,推理出产生不规则抗体的主要血型构成,为引起临床医师对ABO血型系统以外抗体的重视,为以后科学、安全的输血提供技术支撑。方法:1.收集某地某医院2014年6月1日至2014年9月20日共1615例将要配血的患者血浆,做不规则抗体检测,将抗体阳性患者做分型检测,将其所得的结果录入输血科的杏和计算机软件管理系统。2.对收集的1615例配血者标本采用微柱凝胶技术(MGT)与间接抗人球蛋白方法检测红细胞血型系统中ABO血型系统以外的不规则抗体,检测该地区不同人群的不规则抗体检出率,对抗体阳性的患者分别用盐水法、微柱凝胶间接抗人球蛋白方法和经典抗人球蛋白方法进行抗体分型,调查该地区ABO血型系统以外的不规则抗体分布情况及抗体产生的规律和原因。结果:1.通过对1615例患者进行不规则抗体的检测,检出被检者红细胞血型不规则抗体阳性15例阳性率0.93%(15/1615),其中男性检出率为0.67%(4/595),女性检出率为1.08%(11/1020),女性有妊娠史的患者检出率为1.28%(11/857),无妊娠史患者检出率为0(0/163),有输血史患者290例检出率3.45%(10/290),高于无输血史的患者检出率0.38%(5/1325),两者比较差异有统计学意义(P0.05)。2.抗体特异性以抗RH系统最多见检出6例检出率为40%(6/15),其中,抗-E四例、抗-D一例、抗-c一例;其次是Kell和MNSs系统各四例检出率26.67%(4/15)分别为抗-K四例和抗-M一例、抗-s两例、和抗-Mur一例;最后还在Duffy系统中发现Fya一例检出率为6.67%(1/15)。结论:红细胞表面除了具有ABO血型系统抗原以外,Rh、Kell、MNSs和Duffy血型系统抗原也广泛存在,对输血有很大影响。输血会刺激受血者产生ABO血型系统以外的不规则抗体,造成输血免疫反应,影响治疗效果。为此我们要认真做好ABO血型系统以外的不规则抗体筛查、鉴定工作,为科学、安全输血做好技术保障。
[Abstract]:Objective: to screen out the irregular antibody positivity outside the ABO blood group system in a certain area and to identify the irregular antibody. To study the relationship between sex, blood transfusion history, pregnancy history and antibody detection, to grasp the positive rate and type of irregular antibody outside the ABO blood group system in population, and to infer the main blood group composition which produces irregular antibody. In order to cause clinicians to pay more attention to antibodies outside ABO blood group system, and to provide technical support for future scientific and safe blood transfusion. Methods: 1. From June 1, 2014 to September 20, 2014, a total of 1615 blood samples from a certain hospital in a certain place were collected, and irregular antibody tests were carried out, and the patients with positive antibodies were tested for typing. The results were input into apricot and computer software management system of blood transfusion department. 2. Microcolumn gel technique (MGT) and indirect anti-human globulin method were used to detect irregular antibodies outside the ABO blood group system in 1615 blood donors, and the detection rate of irregular antibodies in different populations in this area was detected. The patients with positive antibody were classified by saltwater method, microcolumn gel indirect anti-human globulin method and classical anti-human globulin method, respectively. To investigate the irregular antibody distribution outside the ABO blood group system and the regularity and cause of antibody production in this area. Results: 1. Through the detection of irregular antibody in 1615 patients, the positive rate of red cell blood group irregular antibody was 0.93% (15 / 1615), and the positive rate of male was 0.67% (4 / 595), the positive rate of red blood group irregular antibody was 0.93% (15 / 1615). The positive rate was 1.08% (11 / 1020) in women, 1.28% (11 / 857) in women with pregnancy history, 0 (0 / 163) in patients without pregnancy history, and 3.45% (10 / 290) in 290 patients with history of blood transfusion. The positive rate of the patients with no history of blood transfusion was 0.38% (5 / 1325), the difference was statistically significant (P0.05). The positive rate of anti-RH system was 40% (6 / 15), including four cases of anti-E, one case of anti-D and one case of anti-c. The positive rates of Kell and MNSs were 26.67% (4 / 15) respectively. The positive rates were anti-K in 4 cases and anti-M in 1 case, anti-s in 2 cases and anti-Mur in 1 case, respectively. The positive rate of Fya was 6.67% (1 / 15) in Duffy system. Conclusion: in addition to ABO blood group system antigens, Rh,Kell,MNSs and Duffy blood group system antigens also exist widely on the surface of red blood cells, which have a great influence on blood transfusion. Blood transfusion can stimulate the recipient to produce irregular antibodies outside the ABO blood group system, resulting in transfusion immune response and affecting the therapeutic effect. Therefore, we should do a good job in screening and identifying irregular antibodies outside the ABO blood group system, and provide a good technical guarantee for scientific and safe blood transfusion.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R446.6
本文编号：2471880
[Abstract]:Objective: to screen out the irregular antibody positivity outside the ABO blood group system in a certain area and to identify the irregular antibody. To study the relationship between sex, blood transfusion history, pregnancy history and antibody detection, to grasp the positive rate and type of irregular antibody outside the ABO blood group system in population, and to infer the main blood group composition which produces irregular antibody. In order to cause clinicians to pay more attention to antibodies outside ABO blood group system, and to provide technical support for future scientific and safe blood transfusion. Methods: 1. From June 1, 2014 to September 20, 2014, a total of 1615 blood samples from a certain hospital in a certain place were collected, and irregular antibody tests were carried out, and the patients with positive antibodies were tested for typing. The results were input into apricot and computer software management system of blood transfusion department. 2. Microcolumn gel technique (MGT) and indirect anti-human globulin method were used to detect irregular antibodies outside the ABO blood group system in 1615 blood donors, and the detection rate of irregular antibodies in different populations in this area was detected. The patients with positive antibody were classified by saltwater method, microcolumn gel indirect anti-human globulin method and classical anti-human globulin method, respectively. To investigate the irregular antibody distribution outside the ABO blood group system and the regularity and cause of antibody production in this area. Results: 1. Through the detection of irregular antibody in 1615 patients, the positive rate of red cell blood group irregular antibody was 0.93% (15 / 1615), and the positive rate of male was 0.67% (4 / 595), the positive rate of red blood group irregular antibody was 0.93% (15 / 1615). The positive rate was 1.08% (11 / 1020) in women, 1.28% (11 / 857) in women with pregnancy history, 0 (0 / 163) in patients without pregnancy history, and 3.45% (10 / 290) in 290 patients with history of blood transfusion. The positive rate of the patients with no history of blood transfusion was 0.38% (5 / 1325), the difference was statistically significant (P0.05). The positive rate of anti-RH system was 40% (6 / 15), including four cases of anti-E, one case of anti-D and one case of anti-c. The positive rates of Kell and MNSs were 26.67% (4 / 15) respectively. The positive rates were anti-K in 4 cases and anti-M in 1 case, anti-s in 2 cases and anti-Mur in 1 case, respectively. The positive rate of Fya was 6.67% (1 / 15) in Duffy system. Conclusion: in addition to ABO blood group system antigens, Rh,Kell,MNSs and Duffy blood group system antigens also exist widely on the surface of red blood cells, which have a great influence on blood transfusion. Blood transfusion can stimulate the recipient to produce irregular antibodies outside the ABO blood group system, resulting in transfusion immune response and affecting the therapeutic effect. Therefore, we should do a good job in screening and identifying irregular antibodies outside the ABO blood group system, and provide a good technical guarantee for scientific and safe blood transfusion.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R446.6
【参考文献】
相关期刊论文 前3条
1 曹雅青;李力;;抗-M抗体引起血型正反定型不符一例报告[J];天津医药;2012年11期
2 郭效君;焦晋山;田青;;RhE相同表型输血与不同表型输血疗效对比观察[J];临床血液学杂志(输血与检验);2014年04期
3 杨慧;赵建萍;;有妊娠史女性患者的不规则抗体筛查[J];中国卫生检验杂志;2010年06期
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