【摘要】：目的:篩查某地區(qū)ABO血型系統(tǒng)以外的不規(guī)則抗體陽性情況,并對不規(guī)則抗體進行分型鑒定。研究性別、輸血史、妊娠史與抗體檢出的關系,掌握人群中ABO血型系統(tǒng)以外的不規(guī)則抗體的陽性發(fā)生率及類型,推理出產(chǎn)生不規(guī)則抗體的主要血型構成,為引起臨床醫(yī)師對ABO血型系統(tǒng)以外抗體的重視,為以后科學、安全的輸血提供技術支撐。方法:1.收集某地某醫(yī)院2014年6月1日至2014年9月20日共1615例將要配血的患者血漿,做不規(guī)則抗體檢測,將抗體陽性患者做分型檢測,將其所得的結果錄入輸血科的杏和計算機軟件管理系統(tǒng)。2.對收集的1615例配血者標本采用微柱凝膠技術(MGT)與間接抗人球蛋白方法檢測紅細胞血型系統(tǒng)中ABO血型系統(tǒng)以外的不規(guī)則抗體,檢測該地區(qū)不同人群的不規(guī)則抗體檢出率,對抗體陽性的患者分別用鹽水法、微柱凝膠間接抗人球蛋白方法和經(jīng)典抗人球蛋白方法進行抗體分型,調(diào)查該地區(qū)ABO血型系統(tǒng)以外的不規(guī)則抗體分布情況及抗體產(chǎn)生的規(guī)律和原因。結果:1.通過對1615例患者進行不規(guī)則抗體的檢測,檢出被檢者紅細胞血型不規(guī)則抗體陽性15例陽性率0.93%(15/1615),其中男性檢出率為0.67%(4/595),女性檢出率為1.08%(11/1020),女性有妊娠史的患者檢出率為1.28%(11/857),無妊娠史患者檢出率為0(0/163),有輸血史患者290例檢出率3.45%(10/290),高于無輸血史的患者檢出率0.38%(5/1325),兩者比較差異有統(tǒng)計學意義(P0.05)。2.抗體特異性以抗RH系統(tǒng)最多見檢出6例檢出率為40%(6/15),其中,抗-E四例、抗-D一例、抗-c一例;其次是Kell和MNSs系統(tǒng)各四例檢出率26.67%(4/15)分別為抗-K四例和抗-M一例、抗-s兩例、和抗-Mur一例;最后還在Duffy系統(tǒng)中發(fā)現(xiàn)Fya一例檢出率為6.67%(1/15)。結論:紅細胞表面除了具有ABO血型系統(tǒng)抗原以外,Rh、Kell、MNSs和Duffy血型系統(tǒng)抗原也廣泛存在,對輸血有很大影響。輸血會刺激受血者產(chǎn)生ABO血型系統(tǒng)以外的不規(guī)則抗體,造成輸血免疫反應,影響治療效果。為此我們要認真做好ABO血型系統(tǒng)以外的不規(guī)則抗體篩查、鑒定工作,為科學、安全輸血做好技術保障。
[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.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R446.6

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