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伊朗南部输血依赖型β地中海贫血患者的红细胞同种免疫

RBC alloimmunization in blood transfusion-dependent beta-thalassemia patients in southern Iran.

作者信息

Karimi M, Nikrooz P, Kashef S, Jamalian N, Davatolhagh Z

机构信息

Thrombosis and Hemostasis Unit, Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Int J Lab Hematol. 2007 Oct;29(5):321-6. doi: 10.1111/j.1365-2257.2006.00856.x.

Abstract

beta-thalassemia is considered a severe, progressive anemia, which needs regular transfusions for life expectancy. One of the most important complications of regular blood transfusions may be alloimmunization, which increases the need for transfusion. This study was performed to investigate the production of red cell alloantibodies in beta-thalassemia patients in Shiraz, southern Iran. Blood sampling was performed among 711 beta-thalassemia patients in Dastgheib hospital in 2002-2004. Direct and indirect coombs tests were performed to check the auto and alloantibodies and a panel test was conducted to detect the type of alloantibodies. Auto and alloantibodies were observed among 1.7% and 5.3% of patients, respectively. The most common alloantibodies were Anti-kell (50%) > Anti-Rh (D) (15.8%) > Anti-Rh (E) (10.5%). All the patients who had developed alloantibody were in the age group of 6 years or more. So for decreasing the rate of alloantibody synthesis, we should crossmatched the packed cells for minor blood groups especially for kell and Rh(E) in addition to major blood groups from the start of transfusion.

摘要

β地中海贫血被认为是一种严重的、进行性贫血,患者需要终身定期输血。定期输血最重要的并发症之一可能是同种免疫,这会增加输血需求。本研究旨在调查伊朗南部设拉子β地中海贫血患者红细胞同种抗体的产生情况。2002年至2004年期间,在达斯特盖布医院对711名β地中海贫血患者进行了血液采样。进行直接和间接抗人球蛋白试验以检查自身抗体和同种抗体,并进行谱细胞试验以检测同种抗体的类型。分别在1.7%和5.3%的患者中观察到自身抗体和同种抗体。最常见的同种抗体是抗凯尔(50%)>抗Rh(D)(15.8%)>抗Rh(E)(10.5%)。所有产生同种抗体的患者均在6岁及以上年龄组。因此,为了降低同种抗体的合成率,从输血开始,除了主要血型外,我们还应针对次要血型,特别是凯尔血型和Rh(E)血型对浓缩红细胞进行交叉配血。

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