北京地区孕妇产前抗体筛选

目的 总结北京地区孕妇不规则抗体的特异性及分布.方法 对2016年1～12月送检至北京市红十字血液中心血型室的1007例孕妇标本进行抗体筛选,其中RhD阴性孕妇770例,RhD阳性孕妇237例,并对251例抗体筛选阳性者做抗体鉴定,鉴定其抗体特异性及抗体类型.结果 770例RhD阴性标本中,抗体筛选阳性46例(5.97％),分别为抗-D 39例,抗-D、C5例,抗-E 1例、抗-D、E1例.237例RhD阳性标本中,抗体筛选阳性205例;Rh系统抗体最常见,共检出84例,分别为抗-E 50例,抗-C 2例,抗-c、E 27例,抗-C、e5例;MNS系统抗体62例,分别为抗-M 57例,抗-S 5例;Lewis系统抗体29例,分别为抗-Lea26例,抗-Leb 1例,抗-Lea+抗-Leb 2例;kidd系统抗体3例,分别为抗-JKa2例,抗-JKb 1例;Duffy系统抗-Fyb7例;P系统抗-P1 2例;Kell系统抗-K 1例;多系统抗体,抗-c、E+抗-JKb1例;温自身抗体4例;另有12例患者因抗体水平较弱,未检出抗体特异性.结论 RhD阴性孕妇最常见抗体为抗-D;RhD阳性孕妇常见抗体分别为Rh、MNS和Lewis系统抗体.孕妇体内不规则抗体可引起新生儿溶血病(HDN),并造成交叉配血困难,故孕期对所有孕妇常规行抗体筛选检查非常必要,如阳性应进一步鉴定抗体特异性、抗体类型及抗体效价,这样有助于保障孕产妇输血安全,并能早期预防和治疗新生儿溶血病,以减少严重并发症的发生.

Irregular antibodies detection among pregnant women in Beijing area

Objective To clarify the specificity and distribution of irregular antibodies among pregnant women in Beijing area,and analyze their clinical value accordingly.Methods In 2016,irregular antibodies detection was performed for 1007 pregnant women in our lab.Further,we continued to identify the specificity of antibodies for 251 samples whose antibody screening was positive.Results Among 770 RhD negative samples,we found irregular antibodies in serum of 46 samples (5.97％),the majority were anti-D(39 samples),followed by anti-D、C (5 samples),anti-E and anti-D、E (1sample respectively).Among all 237 RhD positive samples,irregular antibodies were detected in 205 samples.Rh system antibodies were the most frequent,84 cases were identified in total,including anti-E (50 cases),anti-C(1 sample),anti-c、E (27samples) and anti-C、e(5 cases).MNS system antibodies were detected in 62 cases,anti-M in 57cases and anti-S in 5 cases respectively.MNS system antibodies were detected in 29 cases,including anti-lea (26cases),anti-leb (1 case) and anti-lea+ anti-leb(2 cases).We detected anti-JKa in 2 samples,anti-JKb in 1 sample,and anti-Fyb in 7 cases.Additionally,antiP1 (2 cases) anti-K (1 case) and anti-c、E +anti-JKb (1 case) was clarified.Due to weak antibody levels,antibody specificity could not be clarified in 12 patients.Conclusion Anti-D is the most common irregular antibody in the serum of RhD negative pregnant women.Antibodies of Rh、MNS and Lewis system are frequently detected in RhD positive pregnant women.Irregular antibodies in the serum of pregnant women may lead to difficult blood matching during the period of pregnancy and childbirth,meanwhile,upon-mentioned antibodies could result in hemolytic disease of newborn(HDN),so conducting irregular antibody screening for all women during pregnancy is very necessary.If antibody screening is positive,further antibody identification should be carried out.All those measures can help us to ensure the safety of maternal blood transfusion and offer early preventive treatment to reduce severe damage to fetal and neonates.