11 169例孕产妇不规则抗体筛查结果分析

目的 通过分析孕产妇不规则抗体产生的频率与特异性，探讨不规则抗体筛查在孕产妇整个妊娠周期的临床意义。方法 采用微柱凝胶法对2010年1月-2020年12月在解放军总医院第六医学中心输血医学科生产备血的孕产妇做不规则抗体筛查，对抗体筛查结果阳性的做进一步抗体特异性鉴定。结果 11 169例抗体筛查结果中52例为阳性（0.47%），其中Rh血型系统26例（50.0%）；MNS血型系统9例（17.3%）；Lewis血型系统5例（9.6%）；kidd血型系统1例（1.9%）；3例（5.8%）抗体水平较弱，未检出特异性；1例（1.9%）温自身抗体；7例（13.5%）患者拒绝检测。A型Rh阳性15例；B型Rh阳性9例；O型Rh阳性11例；AB型Rh阳性4例；A型Rh阴性4例；B型Rh阴性5例；O型Rh阴性2例；AB型Rh阴性2例。结论 孕产妇抗体筛查阳性不仅会造成交叉配血困难，给安全输血带来难度，而且会造成妊娠生产不良反应，严重的会发生新生儿溶血病。整个妊娠周期的不规则抗体筛查是保障孕产妇安全生产，早预防、早治疗新生儿溶血病，以及孕产妇安全输血的前提，具有重要的临床意义。

Analysis of irregular antibody screening results of 11 169 pregnant women

Objective By analyzing the frequency and specificity of irregular antibody production in pregnant women, we explored the clinical significance of irregular antibody screening in the whole pregnancy cycle of pregnant women. Methods Microcolumn gel method was used to conduct irregular antibody screening for pregnant women who delivered prepared blood in our center from January 2010 to December 2020, and those who were positive in the anti-screening results were further identified as antibody specificity. Results 52 cases (0.47%) were identified as positive in 11 169 cases, including 26 cases(50.0%) of Rh blood group system. Other blood system cases were found, including 9 cases (17.3%) of MNS blood group system 5 cases (9.6%) of Lewis blood group system, 1 case (1.9%) of Kidd blood group system, 1 case (1.9%) of warm autoantibodies, and 3 non-specificity cases (5.8%) with weak antibody level. Seven patients(13.5%) refused to be tested. 15 cases were identified as type A Rh. 9 cases were B type Rh positive. 11 cases were O-type Rh positive. AB-type Rh was positive in 4 cases. Type A RH was negative in 4 cases; B type RH was negative 5 cases; O type RH was negative in 2 cases; AB-type Rh was negative in 2 cases. Conclusion Positive of irregular antibody in pregnant women could not only cause cross-matching difficulties and bring difficulty to safe blood transfusion, but also cause adverse reactions to pregnancy and production, and the most important is the occurrence of neonatal hemolytic disease. The screening of irregular antibodies during the whole pregnancy cycle is the premise of ensuring safe birth, early prevention and early treatment of neonatal hemolytic disease, and safe blood transfusion of pregnant and pregnant women, and has great meaning of application in clinical.