Investigation and analysis of 11 cases of alloimmunization antibody of Duffy blood group system
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摘要: 目的:探讨Duffy血型系统同种抗体产生的情况及分布特点,分析其抗体产生规律及临床意义。方法:分别采用凝聚胺介质方法、强生微柱玻璃珠抗球蛋白卡、中山生科微柱凝胶抗球蛋白卡进行不规则抗体筛选及鉴定,对抗体鉴定出含有Duffy血型系统抗体的标本进一步检测其红细胞Duffy血型系统抗原,并通过病史、妊娠史、输血史、用药史等病历资料分析抗体产生的原因。结果:248 275例患者标本中有11例存在Duffy血型系统抗体,检出率为0.004%,其中抗-Fyb 7例(63.6%),抗-Fya 1例(9.1%),抗-E+抗-Fyb 3例(27.3%),主要为妊娠或输血免疫产生,抗体均为IgG类。且强生玻璃珠抗球蛋白卡检出Duffy系统抗体明显高于凝聚胺介质方法。结论:Duffy血型系统抗体是临床较罕见的不规则抗体,特别是抗-Fya检出率远低于抗-Fyb,与白种人报道不同;采用抗球蛋白法进行检测反应最佳,妊娠和输血引起的同种免疫是Duffy血型抗体产生的主要原因,其在临床安全输血中具有重要意义。Abstract: Objective: To investigate the production and distribution of alloantibodies in Duffy blood group system, and analyze the regularity and clinical significance of alloantibodies.Methods: The irregular antibody of red blood cells was screened and identified by using polyamine method, Ortho Biovue System Poly Cassette and microcolumn gel antiglobulin technique(produced by Zhongshan biotech company). For the samples with Duffy blood group system antibody identified, the red blood cell Duffy blood group system antigen was further detected, and the causes of antibody production were analyzed by medical history, pregnancy history, blood transfusion history, medication history and other medical records.Results: Among the 248 275 cases, 11 cases had Duffy blood group antibody, the detection rate was 0.004%, including 7 cases of anti-fyb(63.6%), 1 case of anti-fya(9.1%), 3 cases of anti-E + anti-fyb(27.3%), which were mainly produced by pregnancy or blood transfusion. All the antibodies were IgG. The positive rate of Duffy antibody detected by Ortho Biovue System Poly Cassette was significantly higher than that of polyamide method.Conclusion: Duffy blood group antibody is a rare irregular antibody in clinic, especially the detection rate of anti-Fyaantibody is far lower than that of anti-Fybantibody, which is different from the white people. The best reaction is detected by anti globulin method. The alloimmunization caused by pregnancy and blood transfusion might be the main cause of Duffy blood group antibody. It might have important significance in clinical safe blood transfusion.
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Key words:
- Duffy blood group /
- irregular antibody /
- anti-Fya /
- anti-Fyb /
- blood transfusion
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