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目的:总结、分析国内患者群体红细胞同种抗体分布特点,为行业制定管理规范提供证据支持。方法:通过中国知识资源总库、中国知网、维普、Pub Med等文献检索系统,分别使用关键词“意外抗体”、“不规则抗体”、“血型抗体”、“溶血性输血反应”以及“新生儿溶血病”检索、分析1994年1月至2013年12月期间发表的中文、英文文献。结果:共有来自于4 800名患者的5 582个同种抗体被检索出,其中排在前10位最常见的同种抗体依次是抗-E(33.9%)、抗-D(18.3%)、抗-c(10.9%)、抗-M(9.9%)、抗-C(8.1%)、抗-E(4.8%)、抗-Lea(3.4%)、抗-P1(2.0%)、抗-Mur(1.6%)和抗-Jka(1.2%);89个回顾性分析报告中住院患者红细胞同种抗体平均阳性率为0.34%;在136例发生溶血性输血反应的病例报告中,频率最高的同种抗体是Rh系统抗体(71.7%),其他抗体主要还包括抗-Jkb(5.9%)、抗-Lea(5.1%)、抗-Jka(3.7%)、抗-M(1.5%)和抗-Mur(1.5%);导致644例新生儿溶血病发生的致病抗体主要来自Rh(93.1%)和MNS(6.0%)两个血型系统。结论:在中国大陆Rh D阴性产妇产后Rh球蛋白预防性使用应该成为产科常规;对于多次输血患者,推荐使用C、E、c、e、Jka和Jkb血型抗原均匹配的供者血液;对于MNS同种抗体应给予足够的关注;抗体筛选细胞盘中宜包含Mur+红细胞。
OBJECTIVE: To summarize and analyze the distribution characteristics of erythrocyte alloantibodies in domestic patient groups and provide evidence support for the formulation of management norms in the industry. Methods: Through the literature search system of China General Knowledge Database, CNKI, VIP, Pub Med and so on, the author used key words of “unexpected antibody”, “irregular antibody”, “blood group antibody” Hemolytic transfusion reaction “and” newborn hemolytic disease "search, analysis of January 1994 to December 2013 published in Chinese and English literature. RESULTS: A total of 5 582 alloantibodies from 4 800 patients were retrieved. Among them, the top 10 most common alloantibodies were anti-E (33.9%), anti-D (18.3%), anti- Anti-C (8.1%), anti-E (4.8%), anti-Lea (3.4%), anti-P1 Mur (1.6%) and anti-Jka (1.2%). The average positive rate of in-patient erythrocyte alloantibodies in the 89 retrospective analysis was 0.34%. Among 136 cases of hemolytic transfusion reaction, the highest frequency was found Alloantibody was Rh system antibody (71.7%). Other antibodies mainly included anti-Jkb (5.9%), anti-Lea (5.1%), anti-Jka -Mur (1.5%). Pathogenic antibodies leading to 644 newborn hemolytic diseases were mainly from two blood group systems, Rh (93.1%) and MNS (6.0%). CONCLUSIONS: The prophylactic use of Rh globulin after Rh D-negative maternal in mainland China should become obstetrical routine; for multiple transfusions, it is recommended to use donor blood with matching C, E, C, e, Jka and Jkb blood group antigens; MNS alloantibodies should be given sufficient attention; antibody screening cell plate should contain Mur + red blood cells.