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目的通过回顾性研究红细胞血型不规则抗体在体内的消减,比较不同特异性不规则抗体的体内消减速率,探讨其特点,为输血相关不规则抗体检测提供参考和数据。方法研究2000-2016年上海地区存在不规则抗体的患者案例(不包括冷抗体,自身抗体和产前检查中发现的不规则抗体)。选择不同时间多次检测的患者,研究其输血史和不规则抗体强度变化,在考虑可比性的前提下,计算各类不规则抗体消减速率。根据不规则抗体检测中的凝集强度为抗体赋值(赋值方法参照AABB),结合检测间隔天数计算不规则抗体消减速率。结果共有110例不规则抗体具有多次检测的可比性数据(抗体特异性包括抗-E/-Ec,抗-Ce/-C,抗-D,抗-Jka,抗-Jkb,抗-Fyb,抗-Dia,抗-Wra,抗-M,抗-S),其中10%的不规则抗体在多次检测中逐渐消减至无法测得。Rh血型系统抗体在体内30 d(下同)平均消减速率0.259/30 d。非Rh血型系统抗体在体内平均消减速率:1.08/30 d。结论不同个体不规则抗体体内平均消减速率差异很大,Rh血型系统不规则抗体在体内平均消减速率低于其它血型系统抗体,由于其消减可能导致输血前检测的漏检和溶血性输血反应,临床输血应该重视对患者以往输血史、妊娠史,特别是以往不规则抗体检出史的了解。
OBJECTIVE: To retrospectively study the in vivo abatement of irregular erythrocyte blood group antibodies and to compare the in vivo abatement rate of different specific and irregular antibodies, and to explore the characteristics of these antibodies to provide reference and data for the detection of irregular antibodies related to blood transfusion. Methods A case-control study of patients with irregular antibodies (excluding cold antibodies, autoantibodies, and irregular antibodies found in prenatal tests) from 2000 to 2016 in Shanghai was performed. Select patients who have been tested multiple times at different times to study the history of blood transfusion and the changes of irregular antibody intensity. Calculate the rate of elimination of various irregular antibodies on the premise of comparability. Antibody assignments were based on agglutination intensities in irregular antibody assays (Assay Method Reference AABB), and the rate of irregular antibody depletion was calculated in combination with the number of days of detection. Results A total of 110 irregular antibodies with comparable data for multiple tests (antibody specificity including anti-E / -Ec, anti-Ce / -C, anti-D, anti- Jka, anti-Jkb, anti-Fyb, Anti-Dia, anti-Wra, anti-M, anti-S), of which 10% of the irregular antibodies gradually diminished to be unmeasurable in multiple tests. Rh blood group antibody in vivo 30 d (the same below) the average reduction rate of 0.259 / 30 d. Antibody in non-Rh blood group in vivo average rate of reduction: 1.08 / 30 d. CONCLUSION: The average rate of elimination of irregular antibodies in different individuals varies widely. The average reduction rate of irregular antibodies in Rh blood system in vivo is lower than that of other blood group antibodies, which may lead to undetected and hemolytic transfusion reactions before blood transfusion. Transfusion should pay attention to the history of patients with previous transfusions, pregnancy history, especially in the past irregular antibody detection history of understanding.