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目的探讨自身免疫性溶血性贫血(AIHA)患者血清中类同种特异性自身抗体的检出率及其分布情况,进行回顾性统计与分析。方法应用抗球蛋白和微柱凝胶技术,对2008年1月~2015年12月,在本院住院需要输血的196名AIHA患者,进行输血前相关血型血清学检测,并且利用谱细胞鉴定AIHA患者血清中和红细胞上的抗体,进一步选择合适的抗原细胞,通过吸收放散试验区分同种抗体与类同种特异性自身抗体,同时对检出抗体的患者红细胞进行相应抗原检测。结果 196例AIHA患者中,共检出自身抗体伴同种抗体86例占43.9%(86/196),单独自身抗体65例占33.2%(65/196),类同种特异性自身抗体45例占23.0%(45/196)。其中,类同种特异性自身抗体中,Rh血型系统抗原占77.8%(35/45),Kidd血型系统抗原占11.1%(5/45),Rh血型系统抗原混合Kidd血型系统抗体占6.7%(3/45),Duffy血型系统抗原占4.4%(2/45),MNSs血型系统抗原占2.2%(1/45)。此外,不同性别患者类同种特异性自身抗体的检出率比较,差异有统计学意义(χ2=6.00,P<0.05)。结论 AIHA患者类同种特异性自身抗体相当常见,多见于抗Rh血型系统抗原,少数见于Kidd血型系统抗原和Duffy血型系统抗原。了解类同种特异性自身抗体的发生频率和分布规律,为其制订适宜的输血方案,可进一步提高临床输血治疗的安全性和准确性。
Objective To investigate the detection and distribution of autoantibodies against autoantibodies in patients with autoimmune hemolytic anemia (AIHA), and to conduct retrospective statistics and analysis. Methods A total of 196 patients with AIHA requiring blood transfusion in our hospital from January 2008 to December 2015 were enrolled in this study. Blood samples were collected before blood transfusion, and AIHA The antibody in the serum of the patient and the erythrocyte are further selected, and the suitable antigen cells are further selected. The same antibody and the same kind of specific autoantibody are distinguished by the absorption and desorption test, and the corresponding antigen is detected in the erythrocytes detected by the antibody. Results Among the 196 patients with AIHA, 86 (43.9%) were autoantibodies and 33 (65/196) were autoantibodies and 45 (45) autoantibodies 23.0% (45/196). Of them, Rh-type systemic antigens accounted for 77.8% (35/45), Kidd blood-type systemic antigens accounted for 11.1% (5/45), Rh-type systemic antigens mixed Kidd blood group antibody accounted for 6.7% 3/45), Duffy blood group antigen accounted for 4.4% (2/45) and MNSs blood group antigen accounted for 2.2% (1/45). In addition, the detection rates of alloantibodies in different sexes were statistically different (χ2 = 6.00, P <0.05). Conclusion AIHA patients are quite common with alloantibodies, which are more common in anti-Rh blood system antigens, a few in Kidd blood group antigens and Duffy blood group antigens. To understand the frequency and distribution of allotype-specific autoantibodies and to develop suitable transfusion regimens to further improve the safety and accuracy of clinical transfusion therapy.