多次输血患者和经产妇中的红细胞同种免疫。
Red cell alloimmunization in multitransfused patients and multiparous women.
作者信息
Patel Jalada, Shukla Rinku, Gupte Snehalata
机构信息
Surat Raktadan Kendra and Research Centre, 1st Floor, Khatodara Health Centre, Near Chosath Jogani Mata Temple Udhna Magdalla Road, Surat, 394 210 Gujarat India.
出版信息
Indian J Hematol Blood Transfus. 2009 Jun;25(2):49-52. doi: 10.1007/s12288-009-0013-7. Epub 2009 Jul 5.
PURPOSE
To determine the incidence of alloimmunization against red cell antigens and the thermal amplitude and specificity of antibodies in multitransfused patients and multiparous women.
METHODS
Antibody screening was performed in 30 nontransfused orthopedic surgery cases (control), 504 multitransfused patients and 325 multiparous women. Antibody screening at 4°C, 22°C and 37°C was carried out in a saline phase, by indirect antiglobulin technique (IAT), using papain cystein, low ionic strength solution (LISS) and polyethylene glycol (PEG).
RESULTS
In multitransfused patients IgM antibodies were more frequently detected at 4°C and the IgG antibody incidence was 7.1% by enzyme method, 7.7% IAT, 9.4% LISS, 10.2% using PEG & 10.2% multiparous women. Bad obstetric history cases had significantly higher incidence of alloimmunization. The antibody specificity of antibodies was mainly in Lewis, Rh, Kidd and MN systems.
CONCLUSION
Antibody screening before transfusion, at set time intervals after transfusion and during antenatal period is recommended.
目的
确定多次输血患者及多产妇女中红细胞抗原同种免疫的发生率以及抗体的热幅度和特异性。
方法
对30例未输血的骨科手术病例（对照组）、504例多次输血患者和325例多产妇女进行抗体筛查。采用间接抗球蛋白技术（IAT），在盐水相中，使用木瓜蛋白酶半胱氨酸、低离子强度溶液（LISS）和聚乙二醇（PEG），于4℃、22℃和37℃进行抗体筛查。
结果
在多次输血患者中，IgM抗体在4℃时更常被检测到，通过酶法检测到的IgG抗体发生率为7.1%，IAT法为7.7%，LISS法为9.4%，PEG法为10.2%，多产妇女中为10.2%。不良产科史病例的同种免疫发生率显著更高。抗体的特异性主要存在于Lewis、Rh、Kidd和MN系统中。
结论
建议在输血前、输血后设定的时间间隔以及孕期进行抗体筛查。
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