• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

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中国献血人群意外抗体阳性率的Meta分析

郭伟洁,刘泽雅,张凡,赫喜荣,常玥,陈利达,王文静,芦宏凯   

  1. 中日友好医院
  • 收稿日期:2020-06-19 修回日期:2020-07-29 发布日期:2020-11-12
  • 通讯作者: 芦宏凯

Meta Analysis on the Unexpected Antibody Positive Rate of Blood Donors in China

  • Received:2020-06-19 Revised:2020-07-29 Published:2020-11-12

摘要： 目的 通过Meta分析估算中国献血人群意外抗体的阳性率，分析我国献血人群红细胞意外抗体的分布特点，为判断我国献血人群是否需要进行意外抗体检测实验提供数据基础。方法 在PubMed、CNKI、WanFang Data、VIP、和 CBM 数据库中，通过输入特定的检索词检索有关我国献血人群意外抗体的相关文献，检索时间为建库时至2019年12月。由五位研究人员按照纳入排除标准独立进行文献筛选、提取相关资料并进行方法学质量评价，使用R3.6.2软件进行Meta分析。结果 共纳入38个横断面研究，Meta分析结果显示：我国献血者的总抗体阳性率为0.20%[95%CI(0.15%,0.25%)]；男性献血者抗体阳性率为0.13% [95%CI(0.10%, 0.16%)]，女性献血者抗体阳性率为0.31% [95%CI(0.26%, 0.37%)]，女性献血者抗体阳性率高于男性抗体阳性率，差异存在统计学意义；其中抗体类型多以IgM型为主，占抗体阳性总数的59.78% [95%CI(50.01%, 69.54%)]，IgG型抗体占抗体阳性总数的31.33% [95%CI(23.44%, 39.22%)]，且IgG型抗体多见于女性；根据抗体鉴定结果发现，各血型系统抗体阳性率不同，Rh系统约占31.64%[95%CI(25.25%,38.03%)]（99.61%为IgG型抗体，以抗-D、抗-E为主），MNS系统约占23.73%[95%CI(18.80%,28.65%)]（88.74%为IgG型抗体，以抗-M为主），Lewis系统约占8.18%[95%CI(5.71%,10.66%)]（主要为IgG型抗体，以抗-Lea为主），P系统约占4.54%[95%CI(2.58%,6.51%)]（主要为IgM型抗体，以抗-P为主），其他类（包括非特异性抗体、自身抗体）占22.78%[95%CI(14.09%,31,46%)]（主要为IgM型抗体），Kell系统约占0.05%[95%(0,0.46%)]，Duffy系统约占0.05%[95%CI(0,0.46%)]（主要为IgG型抗体，以抗-Fya为主），Kidd系统约占0.01%[95%CI(0,0.42%)]（均为抗-Jka），Diego系统约占0.01%[95%CI(0,0.4%)]（均为抗-Dia）；抗体频率排序：抗-M＞抗-D＞抗-E＞抗-Lea＞抗-P。结论 将意外抗体筛查实验纳入献血者常规检测项目存在一定必要性，针对献血者常见意外抗体开发献血者筛查专用谱细胞可降低实验成本，有助于电子交叉配血的实施。

关键词: 中国, 献血者, 意外抗体, Meta分析

Abstract: Objective Estimate unexpected antibody positive rate of Chinese blood donors population through Meta-analysis method, analyze the distribution characteristics of blood donor population RBC unexpected antibodies, and provide database for judging whether Chinese blood donors population need unexpected antibody detection. Methods Using specific search terms to search literatures related to accident antibody of Chinese blood donors population in PubMed, CNKI, WanFang Data, VIP, and CBM databases from the databases establishing time to December 2019, literatures have been screened according to the inclusion and exclusion criteria, R3.6.2 software was used to analyze data derived from selected literatures after methodological quality evaluation. Results A total of 38 cross-sectional studies were included. Meta-analysis results showed that the total antibody positive rate of blood donors in China was 0.20%[95%CI (0.15%,0.25%)].The antibody positive rate of male blood donors was 0.13% [95%CI (0.10%, 0.16%)], and that of female blood donors was 0.31% [95%CI (0.26%, 0.37%)]. The antibody positive rate of female blood donors was higher than that of male blood donors, and the difference was statistically significant. Most of the antibody types were IgM, accounted for 59.78%[95%CI (50.01%, 69.54%)] of the total positive antibody. IgG antibody accounted for 31.33% [95%CI (23.44%, 39.22%)] of the total positive antibody. The positive rate of antibodies in each blood group system was different, Rh system accounted for 31.64%[95%CI(25.25%,38.03%)] (99.61% are IgG antibodies, mainly anti-D and anti-E), MNS system accounted for 23.73%[95%CI(18.80%,28.65%)] (88.74% are IgG antibodies, mainly anti-M), Lewis system accounted for 8.18%[95%CI(5.71%,10.66%)] (mainly IgG antibodies, mainly anti-Lea),P system accounted for about 4.54%[95%CI(2.58%,6.51%)] (mainly IgM antibody, mainly anti-P), other systems (including non-specific antibody and autoantibody) accounted for 22.78%[95%CI(14.09%,31,46%)] (mainly IgM antibody), Kell system accounted for about 0.05%[95%CI(0,0.46%)], Duffy system accounted for about 0.05%[95%CI(0,0.46%)] (mainly IgG antibody, mainly anti-Fya),Kidd system accountedfor about 0.01%[95%CI(0,0.42%)] (all anti-Jka), and the Diego system accountedfor about 0.01%[95%CI(0,0.4%)] (all anti-Dia). Antibody frequency sorting: anti-M> anti-D> anti-E> anti-Lea > anti-P. Conclusion It is necessary to bring the unexpected antibody screening test into the routine testingproject for blood donors. Itwillreducethe experimental cost andbenefitimplementation of electronic cross matchingtodevelopspecial spectrum of blood donor screening cells aimingatcommon accidental antibody ofblood donors.

Key words: China, Unexpected antibody, Blood donors, Meta analysis