输血前不规则抗体筛查与临床输血安全

目的 回顾性分析该院不规则抗体产生的频率及其特异性,探讨不规则抗体筛查阳性时的分析处理方法和临床意义,以确保临床输血安全.方法 对2005年11月至2010年7月在该院拟输血或手术备血的10 479例患者进行不规则抗体筛查,结果阳性的标本送北京市血液中心进行抗体鉴定,分析抗体特异性.结果 检出不规则抗体阳性70例,阳性率为0.67%,其中有临床意义的抗体49例,包括血液病22例、恶性肿瘤12例、良性肿瘤5例、肾病4例、其他疾病6例,血液病和肿瘤患者占79.6%,抗体鉴定确定自身抗体10例;自身抗体和同种抗体4例;确定同种特异性抗体35例.结论 输血前不规则抗体筛查十分必要,发现不规则抗体筛查阳性一定要做进一步的抗体鉴定,并选择无相应抗原的配血相合的血液输注.

Irregular antibody screening before blood transfusion and clinical transfusion safety

Objective To discuss the clinical value and methods of analysis and processing when the irregular antibody screening was positive through a retrospective analysis of frequency and specificity in producing irregular antibodies,in order to ensure clinical transfusion safety.Methods From November 2005 to July 2010,10 479 patients for blood transfusion or surgery in the hospital screened irregular antibodies.The specimens with positive results were sent to Blood Center of Beijing for antibody identification and antibody specificity analysis.Results 70 cases with irregular antibody positive were found in 10 479 patients.Positive rate was 0.67%.There were 49 cases with clinically significant antibodies among them,including 22 cases of hemopathy,12 cases of malignant tumor,5 cases of benign tumor,4 cases of kidney disease,and 6 cases of other diseases.Through the antibody appraisal,it was confirmed 10 cases with auto-antibodies,4 cases with auto-antibodies and allo-antibodies,and 35 cases with specificity allo-antibodies.Conclusion It is necessary to screen irregular antibodies before blood transfusion.If the result of irregular antibody screening is positive,it is be obliged to authenticate antibodies further and choose the blood with no corresponding antigens for transfusion,in order to ensure the safety.