Study On Sensitized Erythrocytes And The Safety Of Blood Transfusion

Objective :Sensitized red blood cell is a non complete antibody or its own antibody and red cell surface antigen binding or attached to the red cell membrane to make it sensitive.Sensitized red blood cells had certain influence on the safety of blood transfusion.In order to understand the sensitivity of red blood cells, especially the occurrence of sensitive red blood cells by antibiotic drug,detecting and calculating the positive incidence of anti human globulin test(AGT) in a certain hospital and caring out antibody specific typing and identification of AGT positive samples. To explore clinical distribution characteristics of AGT positive population.To analysis the relationship between the population of gender,pregnancy history, history of blood transfusion and AGT positive detection and the occurrence of sensitized red cells induced by antibiotics.To understand the disease distribution of AGT positive patients.All of the above is for the sake of improving the AGT as before transfusion checking the importance of understanding and laying a theoretical foundation for clinical safety and rational use of blood.Method :1.To collected EDTA-K2 anti coagulation 5ml of 1595 cases hospitalized patientsin in our hospital from May 1, 2015 to September 30, 2015.After centrifugation,to detect the antibody on red cells and plasma,and the positive specimens further specific antibody typing and identification.2.Combining the micro column gel technology(MGT) and antiglobulin test proteins(AGT) method to detect the plasma and erythrocyte antibodies of 1595 cases of specimens.Direct anti human globulin test(DAT) detection of red blood cell.Indirect anti human globulin test(IAT) detection of plasma. To understand the AGT positive rate of people in the area. DAT positive samples using antibiotic drug induced hemolytic anemia detection kit(micro column gel method) to do the antibody specificity typing.The IAT positive samples were identified by micro column gel method. To analyze the clinical distribution of AGT positive population and its relationship with the disease.3.To collect the case of poor blood transfusion caused by the cephalosporin antibiotics sensitized erythrocytes.Results:1.The detection of 1595 cases patients, AGT positive 124 cases(7.77%), including direct anti human globulin test(DAT) positive in 108 cases(6.77%)and indirect anti globulin protein test(IAT) positive in 16 cases(1.00%). The DAT positive rate of male is7.08%( 50/706), the positive rate of IAT is 0.71%(5/706).The DAT positive rate of female is 6.52%(58/889), the positive rate of IAT is 1.24%(11/889).Women have pregnancy history DAT positive rate is6.54%(4 8/733), IAT detection rate is 1.50%(11/733).Women without pregnancy history DAT positive rate is 6.41%( 10/156), IAT detection rate is 0(0/156).People who had a history of blood transfusion DAT positive rate is 16.41%(65/396), IAT positive rate is 2.78%(11/396), was significantly higher than those people who have no history of blood transfusion DAT positive rate is 3.59%(43/1199),IAT positive rate is 0.42%(5/1199), between the difference was statistically significant(P<0.05).2.DAT positive types will be distributed as 28 cases of Ig G type(25.93%), 70 cases of type Ig G+C3(64.81%), C3 Type 10 cases(9.26%). 12 cases of red cell sensitization induced by autoimmune factors(11.11%), non autoimmune factors sensitizated red cell in96 cases(88.89%), which identified as the cephalosporins induced in 3 cases(3.13%) and non drug dependence of autoantibodies in 8 cases(8.33%). Homologous specific antibodies in 16 cases were identified of IAT positive patients.The highest proportion of antibody in Rh-hr system was 50%(8/16).Among them, anti-E 5 cases, anti-D 1 cases,anti-e 1 cases, anti-c 1 cases.Followed by the MNSs system is 5 cases accounted for 31.25%(5/16), respectively, anti-M 4 cases, anti-Mur 1 cases, the last is Lewis system in the anti-Lea 2 cases accounted for 12.5%(2/16), Kidd system 1 cases accounted for 6.25%(1/16).3.Three cases of patients who were identified as the drug induced erythrocyte sensitization respectively using the cefoperazone sodium and sulbactam sodium,cefuroxime and ceftazidime Ding.Among them,2 cases of patients with transfusion of blood products, the effect of blood transfusion is poor.4.AGT positive rate was higher in these systemic diseases that include blood system,liver and gallbladder diseases and cancer patients.Conclusions:In addition to antibodies to the ABO blood group system,due to immune, blood transfusion and drugs and other factors may induce the body to produce a variety of antibodies in the plasma or in the presence of red blood cells on the cause of sensitization.In particular, with the widespread use of antibiotics, the body produces drug-induced hemolytic anemia cases have occurred.Therefore, we should also test the patient at the same time direct anti human globulin test and irregular antibody screening before the transfusion,especially for repeated transfusion, a large number of antibiotics and patients who have systemic diseases caused by the immune function hyperthyroidism is of great significance,ensuring safe blood transfusion.