Department of Medicine Clinical Laboratory, Xiangya Third Hospital, Central South University, Changsha, China.
Department of Blood Transfusion, The First People's Hospital, Nanning, China.
Allergol Immunopathol (Madr). 2023 May 1;51(3):49-55. doi: 10.15586/aei.v51i3.811. eCollection 2023.
Detection rate, serological characteristics, and clinical data of patients with Lewis blood group antibodies in Hunan Province were analyzed through retrospective analysis. This was undertaken in order to optimize the detection methods and blood transfusion strategies of these patients.
Blood typing, antibody screening, and cross-matching were performed by microcolumn gel, and Lewis antigen was detected by immediate spin test, antibody identification of positive and negative ABO samples, positive antibody screening, and cross-blood mismatch samples. Antibodies were identified by immediate spin test and microcolumn gel antiglobulin method, and the clinical data of the patients with Lewis antibody characteristics were analyzed.
A total of 74 samples (15.91%) with Lewis antibodies were detected from 465 positive samples; cases were distributed in different cities of Hunan Province, with Changsha city being the most frequent (28%) one, with mostly non-O (66), anti-Le (31; 41.89%), anti-Le+anti-Le (23; 31.08%), anti-Le (5; 6.76%), anti-Le and anti-Le+anti-Le (1+4; 6.76%), and antibody types immunoglobulin M (IgM) (51; 68.92%), immunoglobulin G (8; 10.81%), and IgG+IgM (4; 5.41%) cases. Patients included more females (67.57%) than males. The detection rate of gynecological diseases and patients with solid tumors was highest (44.59%). In all cases, the Lewis blood group was Le (a-b-); none of the 15 transfusion patients had hemolytic transfusion reaction.
A variety of experimental methods must be adopted simultaneously to determine specificity and prevent the leakage of Lewis antibodies. The infusion of red blood cells matching with antiglobulin media at 37°C was recommended to ensure safe transfusion for recipients with Lewis antibodies.
通过回顾性分析,分析湖南省Lewis 血型抗体患者的检出率、血清学特征和临床资料,旨在优化这些患者的检测方法和输血策略。
采用微柱凝胶法进行血型鉴定、抗体筛查和交叉配血,采用即刻离心法检测Lewis 抗原,对 ABO 正反定型阳性和抗体筛查阳性、交叉配血不合标本进行抗体鉴定,采用即刻离心法和微柱凝胶抗球蛋白法对阳性抗体进行鉴定,分析具有 Lewis 抗体特征的患者的临床资料。
从 465 例阳性标本中检出 Lewis 抗体 74 例(15.91%),病例分布于湖南省不同城市,长沙市最为多见(28%),以非 O 型(66)为主,抗-Le(31;41.89%)、抗-Le+抗-Le(23;31.08%)、抗-Le(5;6.76%)、抗-Le 和抗-Le+抗-Le(1+4;6.76%)为主,抗体类型以免疫球蛋白 M(IgM)(51;68.92%)、免疫球蛋白 G(8;10.81%)和 IgG+IgM(4;5.41%)为主。患者中女性(67.57%)多于男性。妇科疾病和实体肿瘤患者的检出率最高(44.59%)。在所有病例中,Lewis 血型均为 Le(a-b-);15 例输血患者无一例发生溶血性输血反应。
必须同时采用多种实验方法来确定特异性,防止 Lewis 抗体漏检。建议对具有 Lewis 抗体的受血者输注与抗球蛋白介质在 37°C 孵育相匹配的红细胞,以确保安全输血。