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[血红蛋白病中的抗红细胞和抗人白细胞抗原免疫反应]

[Anti-erythrocyte and anti-HLA immunization in hemoglobinopathies].

作者信息

Ben Salah N, El Borgi W, Ben Lakhal F, Ben Mansour M, Gouider E, Gorgi Y, Bardi R, Zoueri B, Hafsia R

机构信息

Faculté de médecine de Tunis, université Tunis El Manar, rue Jbel Lakhdhar, Tunis, Tunisie.

Faculté de médecine de Tunis, université Tunis El Manar, rue Jbel Lakhdhar, Tunis, Tunisie.

出版信息

Transfus Clin Biol. 2014 Dec;21(6):314-9. doi: 10.1016/j.tracli.2014.10.003. Epub 2014 Oct 30.

Abstract

AIM

Evaluate the anti-erythrocyte and anti-HLA immunization rates in hemoglobinopathies.

PATIENTS AND METHODS

Cross-sectional study (October 2009-March 2010) on 83 patients followed for hemoglobinopathies. The irregular antibodies research is realized by two techniques: indirect Coombs and enzymatic technique on gel cards. The search for anti-HLA class I antibodies is done by complement dependent lymphocytotoxicity.

RESULTS

The mean age was 30 years (14-64 years), the sex ratio M/F is 0.84. Our series included 42 cases of sickle cell disease (29 homozygous sickle cell anemia and 13 sickle-thalassemia) and 41 cases of thalassemia syndromes (26 major and 15 intermediate). The anti-erythrocyte alloimmunization rate is 10.84% without difference between thalassemia syndromes and sickle cell disease. The autoimmunization rate (22.89%) is higher in thalassemia syndromes (41.46%) than in the sickle cell disease (7.14%) (P<0.001). The anti-HLA immunization rate is 31.6% without difference between thalassemia syndromes and sickle cell disease. The young age, transfusion at a young age and the total number of transfusions are the factors that increase the risk of anti-erythrocyte autoimmunization. No clinicobiological parameter does influence the anti-erythrocyte and anti-HLA alloimmunization. There is no significant association between anti-erythrocyte and anti-HLA immunization.

CONCLUSION

The erythrocyte and anti-HLA anti-immunization rates are high in our series. Preventive strategy is needed to ensure optimal blood safety.

摘要

目的

评估血红蛋白病患者的抗红细胞和抗人类白细胞抗原(HLA)免疫发生率。

患者与方法

对83例血红蛋白病患者进行横断面研究(2009年10月至2010年3月)。通过两种技术进行不规则抗体检测:间接抗人球蛋白试验和凝胶卡酶技术。采用补体依赖淋巴细胞毒性试验检测抗I类HLA抗体。

结果

患者平均年龄为30岁(14 - 64岁),男女比例为0.84。本研究系列包括42例镰状细胞病(29例纯合子镰状细胞贫血和13例镰状细胞 - 地中海贫血)和41例地中海贫血综合征(26例重型和15例中间型)。抗红细胞同种免疫发生率为10.84%,地中海贫血综合征和镰状细胞病之间无差异。地中海贫血综合征的自身免疫发生率(22.89%)高于镰状细胞病(7.14%)(P<0.001)。抗HLA免疫发生率为31.6%,地中海贫血综合征和镰状细胞病之间无差异。年龄小、幼年输血以及输血总量是增加抗红细胞自身免疫风险的因素。没有临床生物学参数影响抗红细胞和抗HLA同种免疫。抗红细胞和抗HLA免疫之间无显著关联。

结论

本研究系列中红细胞和抗HLA抗免疫发生率较高。需要采取预防策略以确保最佳血液安全。

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