不规则抗体的筛查在安全输血中的价值

随机选取1 560例输血患者血样,输血前均于微柱凝胶技术行不规则抗体筛查,含不规则抗体标本检出68例,占总标本数的4.40%。其中Rh系统抗体占比67.65%(46/68),MNS系统抗体占比32.35%(22/68)。输血前对不规则抗体进行筛查可有效检出各不规则血型抗体,尽可能减少临床输血诸多并发症的发生,具有临床应用与推广价值。     

广州地区1226507例无偿献血者梅毒筛查结果分析

目的了解广州地区无偿献血者梅毒感染状况,确定梅毒感染低危人群,为安全输血提供有效的预防措施。方法选择广州地区2005—2009年无偿献血者梅毒筛查数据进行分析。梅毒血清学筛查试验采用ELISA试验,梅毒血清学筛查阳性标本采用TPPA试验确认。结果1226507例无偿献血者中梅毒阳性率为0．45％。其中单位员工、大专院校学生、流动人员和其他献血人员（包括无偿机采成分献血者）梅毒抗体阳性率分别为0．44％、0．14％、0．69％、0．29％;年龄在20～39岁梅毒抗体阳性献血者5126例,占梅毒抗体阳性者的93．4％;梅毒阳性率不同年龄和职业分布差异均有统计学意义（P〈0．01）。各年份无偿献血者中梅毒抗体阳性率差异无统计学意义（P〉0．05）。结论广州地区2005—2009年无偿献血人群梅毒感染率保持相对稳定水平,无明显上升趋势。大专院校学生和单位员工为梅毒感染低危人群,可作为主要献血人群,发展献血者队伍。采供血部门应加强对流动人员的无偿献血筛查工作,以保证血液安全。     

输血安全与不规则抗体筛选

观察临床9857例输血患者不规则抗体筛查实验结果,检测出抗体阳性32例,降低并有效避免了溶血反应的发生.因此,对输血前患者进行不规则抗体筛选是必要的,在保证临床输血安全、减少溶血性输血反应方面具有重要意义.     

两种不规则抗体筛查试验的应用比较

目的比较两种不规则抗体筛查试验的准确性和敏感性。方法将凝聚胺法筛查出的不规则抗体阳性标本23例,用微柱凝胶法进行不规则抗体的复检,然后用经典抗人球蛋白法验证。以经典抗人球蛋白法为标准,分析微柱凝胶法和凝聚胺法的假阳性率。结果凝聚胺法的假阳性率为8.7%;微柱凝胶法无假阳性;3种不规则抗体检测方法的差异无统计学意义。结论凝聚胺法和微柱凝胶法用于不规则抗体筛查的敏感性均高,凝聚胺法有一定程度的假阳性率。广谱抗人球蛋白微柱凝胶法的方法简单,规范,可以代替经典抗人球蛋白法筛查不规则抗体。     

北京市某医院献血者不规则抗体筛查阳性结果分析

目的 通过交叉配血次侧不合发现不规则抗体筛查阳性的献血者并鉴定不规则抗体特异性,保障输血安全。方法通过交叉配血次侧均不相合且复查血型发现不规则抗体筛查阳性的献血者,并鉴定抗体特异性;将其中4袋不规则抗体筛查阳性的悬浮红细胞制备为洗涤红细胞,并跟踪其输注效果。结果 2016年11月至2017年12月期间,34297例献血者中发现11例为不规则抗体筛查阳性,其中抗-E5例、抗-M4例、自身抗体1例、非特异性抗体1例。两名患者输注抗筛阳性洗涤红细胞后,输注有效,无不良输血反应发生。结论 常规开展献血者不规则抗体筛查项目具有重要的临床意义,将抗筛阳性的悬浮红细胞制备为洗涤红细胞,可以保障输血安全,节约血液资源。     

重型β地贫儿童血清不规则抗体筛查与鉴定分析

目的了解重型β地中海贫血（地贫）儿童血清中不规则抗体的发生率及其特异性抗体构成。方法对选取的142例反复输血的β地贫双重杂合子（或纯合子）进行不规则抗体筛查和鉴定检测,统计分析其检出率及构成比。结果不规则抗体筛查阳性率为9.2%,具体分布如下：Rh系统11例（84.6%）,其中抗-E最多（占30.8%）,P系统1例（7.7%）;Kidd系统1例（7.7%）;而产生不规则抗体的重型β地贫的基因型中CD41-42/CD41-42比例最高（占30.8%）。结论反复输血的重型β地中海贫血患儿不规则抗体阳性率较高,要特别注意对Rh系统不规则抗体的检查。     

不规则抗体的筛查和鉴定在临床输血中的意义

目的检查有输血史或妊娠史的患者血清（浆）中的不规则抗体，降低或避免溶血性输血反应的发生。方法用微柱凝胶coombs IgG卡对6486例有输血史或妊娠史患者的血标本进行不规则抗体筛查和鉴定，将不规则抗体阳性的标本用coombs IgG卡进行交叉配血。结果不规则抗体阳性24例，阳性率0．37％。其中，抗-D3例，抗-E4例，抗-C2例，抗-A1 1例，抗-M2例，抗-EC2例，抗-Cc 1例，抗-JKa 2例，抗-JK^b1例，抗-FY^a2例，抗-Le^a 1例，非特异性抗体3例。结论不规则抗体筛查能有效降低或避免溶血性输血反应的发生，保证输血安全，对有输血史和妊娠史的患者尤为重要。     

拟输血患者血型不规则抗体检测结果的回顾性分析北大核心CSCD

目的探讨拟输血患者血型不规则抗体的检出及分布情况,以指导临床合理安全用血。方法应用盐水法、抗人球蛋白法和微柱凝胶技术对58 565例拟输血住院及急诊患者进行血型不规则抗体检测,对阳性结果进一步采用谱细胞进行抗体特异性鉴定。结果共检出不规则抗体阳性351例,检出率为0.60%(351/58 565)。鉴定出特异性抗体282例,检出率为0.48%(282/58 565);自身抗体36例,检出率为0.06%(36/58 565);无法鉴定抗体特异性共33例,占0.06%(33/58 565)。不同性别患者不规则抗体的检出率比较:女性患者222例,阳性率为0.73%(222/30 582)显著高于男性患者129例,阳性率为0.46%(129/27 983)。结论拟输血患者有必要进行不规则抗体筛查和特异性鉴定,避免免疫性输血反应的发生。     

输血前患者不规则抗体筛查及鉴定的临床意义探讨

目的:分析输血前患者不规则抗体的产生、分布情况及其临床意义.方法:采用微柱凝胶抗人球蛋白卡对85645例输血前患者进行不规则抗体筛查并鉴定.结果:不规则抗体的产生率为0.37％(313/85645),特异性抗体201例(64.22％),其中Rh系统患者最多,达121例(38.67％).针对不规则抗体检出率,外科(0.5...     

7596例患者血清不规则抗体分析与临床意义

<正>不规则抗体是指不符合ABO血型Landsteiner规则的血型抗体,即抗A、抗B以外的血型抗体;常通过异型输血、妊娠免疫刺激产生,以Ig G为主,少部分为Ig M;Ig G现已成为引起交叉配血困难[1-2]和免疫溶血性输血反应的重要影响因素。不规则抗体检查是保证安全输血的重要实验,本研究将对7596例患者的不规则抗体检查结果进行总结分析。1材料和方法     

The prevalence of anti-latex IgE antibodies in 1000 volunteer blood donors

BACKGROUND: Latex allergy has been recognized as a medical problem with increasing frequency since the mid 1980s. Although certain groups of individuals, such as health care workers, have been recognized as having increased risk for latex allergy, little is known about the prevalence of latex allergy in the general population. METHODS: To estimate the prevalence of latex allergy among healthy adults, we measured anti-latex IgE antibodies in residual serum samples from 1000 volunteer Red Cross blood donors. The 1000 samples were from a sample of blood units collected from workplace mobile sites throughout Southeastern Michigan. Samples collected from mobile sites operating at health care institutions were excluded to minimize sampling of health care workers. Anti-latex IgE antibodies were measured by using the AlaSTAT assay (Diagnostic Products Corp., Los Angeles, Calif.) according to the manufacturer’s directions. Samples with anti-latex IgE concentrations of 0.35 IU/ml or greater were classified as positive and samples with IgE concentrations of 1.50 IU/ml or greater were classified as strongly positive. All positive samples were assayed a second time to confirm the result. All positive samples were also measured with the CAP assay (Pharmacia Diagnostics, Dublin, Ohio). RESULTS: The samples tested were from donors with a mean age of 37.8 years, and 47% were women. Sixty-four (6.4%, 95% confidence interval = 4.9-8.1%) of the samples were confirmed as repeatedly positive for anti-latex IgE, and 23 of the 64 positive samples were strongly positive (2.3% of the 1000). Sixty-one percent of the samples positive as determined by the AlaSTAT assay were also positive as determined by the CAP assay. Samples from male donors were more likely to be positive than those from female donors (8.7% vs 4.1%, p = 0.003). Prevalence of positive samples was not related to age or race. CONCLUSIONS: We conclude that the prevalence of detectable anti-latex IgE antibodies, in a large and relatively unselected adult population, is higher than previous estimates have suggested. Although the clinical significance of these observations needs further evaluation, the data suggest that latex allergy is not confined to individuals in previously recognized high-risk groups. (J Allergy Clin Immunol 1996;97:1188-92.)     

High prevalence of anti-hepatitis E virus antibodies in blood donors from South West France

Cases of autochthonous acute hepatitis E occur in most industrialized countries and are frequent in the South West of France. The prevalence of anti-hepatitis E virus (HEV) IgG antibodies in blood donors in this area was determined. A total of 529 samples from rural and urban blood donors were tested. The overall prevalence was 16.6%, 19.1% of rural donors and 14.2% of urban donors had anti-HEV antibodies (P = 0.13). The antibodies were widely distributed among all age groups and the sex ratio of the anti-HEV positive blood donors was 1.12 (P = 0.57). Hunting was the only pastime or profession associated with a high prevalence of anti-HEV antibodies (P = 0.038). The frequency of anti-HEV antibodies in blood donors could reflect active autochthonous transmission in this area of France. As the risk factors for HEV infection in industrialized countries are still unknown, further studies are needed to clarify the epidemiology of HEV infection in the Midi-Pyrénées region.     

东莞市2006—2011年献血人群构成分析

目的了解2006—2011年东莞市无偿献血人群的构成特点,为今后东莞市无偿献血宣传工作提供科学依据。方法对东莞市2006—2011年无偿献血人群一般情况及献血情况的资料进行统计分析。结果2006—2011年无偿献血共396984人次,献血人群男、女性别比为2．28：1;献血者文化程度多为初、高中,分别占总人数36．52％及27．01％：献血者职业以“生产、运输设备操作人员”者最多,占22％。2007—2011年每年2月献血人次为当年最低。固定献血者具有男性献血者多、捐献血小板者多、单次献血量较大、检验合格率高的人群特征。结论东莞市无偿献血的重点人群是工人,应加强对非工人人群（如在校学生、企事业单位职工等）的无偿献血宣传,鼓励更多的献血者成为固定献血者。     

东莞市2008—2012年无偿献血者HIV感染状况分析

目的了解东莞市无偿献血HIV感染流行趋势及人群特征,为安全输血和献血招募提供依据。方法分析2008—2012年东莞市无偿献血者121例HIV抗体阳性情况,利用SPSSl6．0软件进行统计分析。结果2008—2012年东莞市无偿献血者中HIV感染率分别为15／10万、21／10万、32／10万、45／10万和51／10万,平均感染率为34／10万,各年间比较差异有统计学意义（x2=19．89,P〈0．05）。男性感染率为44／10万,女性感染率为9／10万,男性高于女性（X2=27．31,P〈0．05）。36-岁组感染率为49／10万,为各年龄组最高（X2=12．94,P〈0．05）。初中以下学历感染率为43／10万,与高中／中专组比较差异有统计学意义（x2=4．47,P〈0．05）。再次献血者感染率低于首次献血者（X2=17．47,P〈0．05）。集体组织献血与个人献血差异无统计学意义（x2=2．84,P〉0．05）。结论东莞市无偿献血者HIV感染率呈逐年上升趋势,HIV感染已从高危人群向一般人群扩散。采供血机构在严格进行抗-HIV筛查时,还应加强献血者特别是低学历青壮年男性的献血前健康征询。     

Introduction of a program for voluntary blood donations in Iran (blood transfusion status in Iran)

Background A national and well-coordinated system is very effective for blood self sufficiency of a country; this system might be committed to follow all requirements and standards. It should manifest itself strong and well-established in reality and practice so that all potential donors trust it and contribute. Iranian Blood Transfusion Organization (IBTO) is an example of a centralized network with 200 centers in 31 provinces which could only be decentralized in some aspects of blood donor recruitment based on the cultural and regional attributes of the people there. Methods The mission of IBTO is to provide and ensure a safe and adequate blood supply in Iran. Selection of low risk donors in pre-donation consultation and interview sessions based on behavioral, medical and demographic factors has improved the transfusion safety even before specific lab screening tests have been conducted; Standardization of criteria for donor eligibility and exclusion, and donor screening procedures are all priorities and most importantly the collection of all blood donations just from voluntary nonremunerated (VNR) blood donors. In fact, a lot of efforts concentrated on recruitment of VNR donors and to this end the Blood Donor Recruitment and Retention Office was established. A variety of measures were made to increase the number of voluntary regular donors including technical efforts, information dissemination activities, demographic studies, campaigns, awareness raising programs, publicity, publications, commemorative ceremonies and the like. Results The annual donation index in Iran has greatly increased from 0.39 in 1974 to 25.3 in 2010–2011. Accordingly we have been witness to increasing trend of blood donation reaching about 2 million blood units in 2011, all of which obtained from voluntary non-remunerated blood donors with the annual index of 26 per 1000 population. Conclusions It shows that every country based on its needs should establish a very effective and safe program to raise the number of its voluntary blood donors and to this end centralization of activities monitored by a headquarters and implementation of an efficient recruitment plan by which all aspects are covered and monitored: ranging from stages prior to donor selection including campaigns and activities to motivate populations to embark on donation, donor selection, screening, retention, statistical audit, continuous evaluation of donation sites, ease of access to donation centers, demographic attributes, donor reactions, to post donation era to ensure high return rate and so on so forth. All in all, availability and affordability are the issues which should be always guaranteed.     

Characterization of blood donors with high haemoglobin concentration

The literature contains little on the prevalence and causes of high predonation haemoglobin levels among blood donors. This study aimed to characterize and develop an algorithm to manage would-be donors with polycythaemia. Between November 2009 and November 2011, we offered haematology consultations to blood donors with repeated haemoglobin concentration (Hb) above the WHO limit for polycythaemia vera (PV) (10.2 and 11.5 mm ⁄ 16.5 and 18.5 g/dl for women and men, respectively). Investigation of such donors included Hb, haematocrit, mean cell volume, erythropoietin, ferritin, platelet count and leucocyte count, JAK2 V617F and JAK2 exon12 analysis, as well as other routine measurements. Among 46 such donors, 39 had a history of smoking, which contributes to erythrocytosis. Two had PV, five had severe hypertension, one of them because of renal artery stenosis, and two had diabetes mellitus. Thus, we found a high morbidity among such donors. Of the 36 others, 30 donated again before May 2012, at which time the Hb was significantly lower. We recommend JAK2 V617F and JAK2 exon12 screening and clinical investigation for donors with concurrently high Hb, high haematocrit and iron deficiency. We also recommend that they stop or cut down on smoking to reduce the risk of thrombosis in general. We disqualified 10 of the donors.