Analysis of results of screening weak positive irregular antibodies by microcolumn glass bead method
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摘要: 文章分析弱阳性不规则抗体的特征及分布，探讨提高此类抗体的检出策略。回顾性分析2019年12月—2023年3月不规则抗体筛查标本5 117例，其中55例不规则抗体筛查呈现弱阳性(凝集强度≤1+)标本纳入研究，对弱阳性标本进行抗体特异性鉴定，分析其性别、输血史、妊娠史、不同介质及科室、疾病的分布关系。弱阳性不规则检出率为1.07%；检出抗体包括MNS血型系统抗体28例(50.9%)，Lewis血型系统抗体13例(23.6%)，Rh血型系统抗体4例(7.3%)，Diego血型系统1例(1.8%)和冷抗体2例(3.6%)，特异性不明确抗体7例(12.7%)；女性39例(70.9%)；有妊娠史的31例(56.4%)；无输血史的48例(87.3%)；弱阳性不规则抗体在抗人球蛋白介质中全部被检出，盐水介质中42例被检出(76.4%)；外科患者42例(76.4%)，内科患者8例(14.5%)；手术患者20例(36.4%)，孕检患者14例(25.5%)。检出的弱阳性不规则抗体主要分布在MNS血型系统和Lewis血型系统，应重视手术患者和孕妇的不规则抗体筛查，联合微柱玻璃珠法和盐水法可提高弱阳性不规则抗体的检出率。
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关键词:
- 不规则抗体筛查 /
- 弱阳性不规则抗体 /
- MNS血型系统抗体 /
- Lewis血型系统抗体 /
- 抗体分布
Abstract: To analyze the characteristics and distribution of weak positive irregular antibodies, and explore strategies to improve the detection of such antibodies. Retrospective analysis of 5 117 irregular antibody screening samples from December 2019 to March 2023, of which 55 samples showing weak positivity(agglutination strength ≤ 1+) in irregular antibody screening were included in the study. Antibody specificity identification was performed on weak positivity samples, and the distribution relationship between gender, blood transfusion history, pregnancy history, different media, departments, and diseases was analyzed. The detection rate of weak positive specimens was 1.07%. Antibodies were detected in 28 cases(50.9%) of MNS blood group system, 13 cases(23.6%) of Lewis blood group system, 4 cases(7.3%) of Rh blood group system, 1 case(1.8%) of Diego system and 2 case(3.6%) of cold antibody, and 7 cases(12.7%) of unclear specificity antibody; 39 females(70.9%); 31 cases(56.4%) had a history of pregnancy; 48 cases(87.3%) had no history of blood transfusion; All weak positive irregular antibodies were detected in the anti human globulin medium, and 42 cases(76.4%) were detected in saline media; There were 42 surgical patients(76.4%) and 8 internal medicine patients(14.5%); 20 operation patients(36.4%) and 14 pregnancy test patients(25.5%). The weak positive irregular antibodies detected are mainly distributed in MNS blood group system and Lewis blood group system. Attention should be paid to the irregular antibody screening of surgical patients and pregnant women. The combined method of microcolumn glass bead and saline method can improve the detection rate of weak positive irregular antibodies. -
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表 1 弱阳性抗体的频率、特异性及性别、输血史、妊娠史中的分布
例(%) 抗体系统 总数(n=55) 男(n=16) 女(n=39) 妊娠史 输血史 有(n=31) 无(n=24) 有(n=7) 无(n=48) MNS系统 抗-M 27(49.1) 6(37.5) 21(53.8) 17(54.8) 10(41.7) 1(14.3) 26(54.2) 抗-S 1(1.8) 1(6.3) 0 0 1(4.2) 0 1(2.1) Lewis系统 抗-Lea 11(20) 3(18.8) 8(20.5) 4(12.9) 7(29.2) 1(14.3) 10(20.8) 抗-Leb 2(3.6) 0 2(5.1) 2(6.5) 0 0 2(4.2) Rh系统 抗-D 1(1.8) 0 1(2.6) 1(3.2) 0 0 1(2.1) 抗-Ec 2(3.6) 1((6.3) 1(2.6) 1(3.2) 1(4.2) 2(28.6) 0 抗-Ec合并自身抗体 1(1.8) 1(6.3) 0 0 1(4.2) 1(14.3) 0 Diego系统 抗-Wra 1(1.8) 0 1(2.6) 1(3.2) 0 0 1(2.1) 冷抗体 2(3.6) 1(6.3) 1(2.6) 1(3.2) 1(4.2) 1(14.3) 1(2.1) 抗体不明确 7(12.7) 3(18.8) 4(10.3) 4(12.9) 3(12.5) 1(14.3) 6(12.5) 
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表 2 弱阳性抗体不同介质中的分布
例(%) 抗体系统 抗人球介质(n=55) 盐水介质(n=42) 抗-M 27(49.1) 25(59.5) 抗-S 1(1.8) 1(2.4) 抗-Lea 11(20.0) 9(21.4) 抗-Leb 2(3.6) 1(2.4) 抗-D 1(1.8) 0 抗-Ec 2(3.6) 0 抗-Ec合并自身抗体 1(1.8) 0 抗-Wra 1(1.8) 1(2.4) 冷抗体 2(3.6) 2(4.8) 抗体不明确 7(12.7) 3(7.2)
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表 3 弱阳性抗体科室及病种分布
科室 例(%) 疾病类型 例(%) 外科科室 42(76.4) 手术 20(36.4) 妇产科 20(47.6) 孕检 14(25.5) 肝胆外科 6(14.3) 贫血 5(9.1) 泌尿外科 2(4.8) 炎症 5(9.1) 关节外科 6(14.3) 肿瘤 5(9.1) 胃肠外科 6(14.3) 脑血管疾病 5(9.1) 脊柱外科 1(2.4) 肝功能不全 1(1.8) 胸外科 1(2.4) 内科科室 8(14.5) 内分泌血液科 2(25.0) 康复医学科 2(25.0) 消化内科 2(25.0) 呼吸科 1(12.5) 肾病风湿科 1(12.5) 其他科室 5(9.1) 急诊科 4(80.0) ICU 1(20.0)
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