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临床输血与检验

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (3): 338-342.DOI: 10.3969/j.issn.1671-2587.2022.03.013

• 临床输血 • 上一篇    下一篇

直接抗人球蛋白试验阳性分型与输血疗效关系探讨*

康晓珍, 彭炜童, 魏寿忠   

  1. 352100 宁德师范学院附属宁德市医院输血科
  • 收稿日期:2021-10-25 出版日期:2022-06-20 发布日期:2022-06-22
  • 通讯作者: 魏寿忠,男,主任技师,研究生,主要从事临床输血免疫学研究,（E-mail）weishouzhong2006@126.com。
  • 作者简介:康晓珍（1987-）,女,福建宁德人,主管技师,本科,主要从事临床输血免疫学研究,（E-mail）sadie871116@163.com。
  • 基金资助:
    *本课题受福建医科大学启航基金项目（No.2018QH1218）资助

The Role of Positive Direct Antiglobulin Test in Blood Transfusion Effectiveness

KANG Xiao-zhen, PENG Wei-tong, WEI Shou-zhong   

  1. Department of Blood Transfusion,Ningde Municipal Hospital of Ningde Normal University,Ningde 352100
  • Received:2021-10-25 Online:2022-06-20 Published:2022-06-22

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摘要： 目的 本研究旨在分析直接抗人球蛋白试验（DAT）阳性分型与输注红细胞后疗效的关系。方法 通过回顾性分析83例DAT试验阳性输血患者的病历资料,对患者的疾病类型、血常规、DAT阳性分型及凝集强度、红细胞输注后疗效等进行统计分析,并与DAT阴性组进行比较。结果 DAT阳性输血患者常见疾病类型是血液病、感染性疾病、肾脏疾病和其他不明原因情况,分别有36例（43.37%）、22例（26.51%）、7例（8.43%）、7例（8.43%）。Hb、RBC、Hct上升值/U DAT阳性组分别为5.75±3.71（g/L）、0.19±0.14（1012/L）、1.65±1.28（%）,阴性组分别为8.09±3.57（g/L）、0.24±0.15（1012/L）、2.43±1.28（%）,阳性组均低于阴性组,差异均有统计学意义（P<0.05）。DAT阳性组输血有效率（61.48%,83/135）明显低于DAT阴性组（80.74%,109/135）（P<0.01）。DAT阳性分型后,IgG+C3d组、IgG组、C3d组输血后的Hb上升值/U分别是8.20±4.65、5.73±3.53、2.01±2.55,其中C3d组Hb上升值/U低于阴性组（Hb上升值/U：8.09±3.57）、IgG+C3d组、IgG组,差异有统计学意义（P<0.05）;IgG组Hb上升值/U低于阴性组、IgG+C3d组,差异有统计学意义（P<0.05）。输血有效率IgG+C3d组（90.00%）>IgG组（61.34%）>C3d组（16.67%）,差异有统计学意义（P<0.05）。DAT阳性分型后不同凝集强度对输注红细胞疗效的影响,差异均无统计学意义（P>0.05）。结论 DAT阳性常见于血液病及感染性疾病,DAT阳性患者输注红细胞后有效率降低,可能与DAT阳性分型有关。DAT阳性患者输血应严格掌握适应证,确保患者安全、有效输血。

关键词: 直接抗人球蛋白试验, 输血, 输注疗效

Abstract: Objective To analyze the relationship between positive direct antiglobulin test （DAT） and efficacy of red blood cell（RBC） transfusion. Methods Medical records of 86 DAT-positive patients accepting RBC transfusion were retrospectively analyzed. The characters including disease type,blood count,DAT-positive type,agglutination intensity and therapeutic impact of RBC transfusion were analyzed,compared with DAT-negative group. Results The common types of diseases in DAT-positive blood transfusion patients were hematological diseases（36,43.37%）,infectious diseases（22,26.51%）,kidney diseases（7,8.43%） and other unknown causes（7,8.43%）. The values of Hb,RBC,and Hct in DAT-positive group were 5.75±3.71（g/L）,0.19±0.14（1012/L）,1.65±1.28（%）,whereas the values in DAT-negative group were 8.09±3.57（g/L）,0.24±0.15（1012/L）,2.43±1.28（%）. The values in DAT-positive group were lower than that in DAT-negative group,and there were statistically significant differences（P<0.05）. The effective rate of blood transfusion in DAT-positive group（61.48%, 83/135） was significantly lower than that in DAT-negative group（80.74%,109/135）（P<0.01）. By DAT-positive typing,the values of Hb after blood transfusion in IgG+C3d group,IgG group,and C3d group were 8.20±4.65 U,5.73±3.53 U,2.01±2.55 U,respectively. The value of Hb in C3d group was lower than that in negative group（Hb 8.09±3.57 U）,IgG+C3d group and IgG group,and the difference were statistically significant（P<0.05）. The value of Hb in IgG group was lower than that in negative group and IgG+C3d group,and the difference were statistically significant（P<0.05）. The effective rate of blood transfusion in IgG+C3d type （90.00%）>IgG group（61.34%）>C3d group（16.67%）,and the difference were statistically significant（P<0.05）. There was no statistically significant difference in efficacy of different agglutination intensities on RBC transfusion by DAT-positive typing （P>0.05）. Conclusion DAT-positive is common in patients with hematological diseases and infectious diseases. The effective rate of DAT-positive patients decreases after RBC transfusion,which may be related to DAT-positive typing. Blood transfusion indications for DAT-positive patients should be strictly controlled to ensure safe and effective blood transfusion.

Key words: Direct antiglobulin test, Blood transfusion, Transfusion efficiency

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