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接受十次或更多次输血的地中海贫血患者中的红细胞同种抗体

Red Cell Alloantibodies in Thalassaemia Patients Who Received Ten or More Units of Transfusion.

作者信息

Sarkar S K, Shah M S, Begum M, Yunus A M, Aziz M A, Kabir A L, Khan M R, Rahman F, Rahman A

机构信息

Dr Surozit Kumar Sarkar, Resident, Department of Haematology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2019 Apr;28(2):364-369.

Abstract

Thalassaemia patients are the highest consumers of blood. Recurrent exposure to allogenic red cell antigen puts this population at increased risk of alloimmunization. This causes delayed hemolytic transfusion reactions. So transfusion requirement increases. But no data regarding alloimmunization was available in Bangladesh. Aim of this study was to estimate the prevalence of alloimmunization and to find out the potential factors associated with its development. This analytical cross sectional study was done by enrolling 97 patients, received at least 10 units transfusions, through convenient sampling. Indirect and direct antiglobulin tests were done to detect immunization by spin tube technique keeping an autocontrol and carried out in the Department of Haematology & Department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from March 2016 to March 2017. Polyclonal anti-AHG reagent was used. A total 21 patients developed alloimmunization (21.6%) and 4 patients (4.1%) developed autoimmunization. Age, gender, splenectomy and number of transfusion are shown significant risk factors for alloimmunization. Data from this study demonstrate that the RBC alloimmunization is significantly high in our country. So, pretransfusion antibody screening needs to be initiated in order to ensure safe transfusion and RBC phenotyping should be started before starting first transfusion to prevent alloimmunization.

摘要

地中海贫血患者是血液的最大消耗群体。反复接触同种异体红细胞抗原使该人群发生同种免疫的风险增加。这会导致迟发性溶血性输血反应。因此输血需求增加。但孟加拉国尚无关于同种免疫的数据。本研究的目的是估计同种免疫的患病率,并找出与其发生相关的潜在因素。本分析性横断面研究通过方便抽样纳入了97例接受过至少10单位输血的患者。2016年3月至2017年3月在孟加拉国达卡的班加班杜·谢赫·穆吉布医科大学(BSMMU)血液学系和输血医学系,采用试管旋转技术并设置自身对照,进行间接和直接抗球蛋白试验以检测免疫情况。使用了多克隆抗人球蛋白试剂。共有21例患者发生了同种免疫(21.6%),4例患者(4.1%)发生了自身免疫。年龄、性别、脾切除术和输血次数是同种免疫的显著危险因素。本研究数据表明我国红细胞同种免疫发生率显著较高。因此,为确保安全输血需要开展输血前抗体筛查,并且应在首次输血前开始进行红细胞表型分析以预防同种免疫。

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