目的 调查广西长期反复输血的地中海贫血患者同种异体免疫发生率,并鉴定同种异体抗体特异性,为临床完善输血策略、提高患者生存质量提供依据.方法 利用地中海贫血管理系统,收集2017-01/2022-06月在作者医院进行输血治疗的1115例患者的资料,统计同种异体抗体阳性发生率,比较不同类型地中海贫血、民族、性别、年龄段以及同种异体抗体阳性发生率,比较不同类型地中海贫血抗体阳性和阴性患者的年龄、Hb水平,对地中海贫血抗体阳性患者抗体进行特异性鉴定.结果 1115例地中海贫血患者中有92例(8.25％)抗体筛查阳性.对比重型β地中海贫血(beta-thalassemia major,β-TM)、血红蛋白 H 病(hemoglobin H disease,HbH),中间型 β 地中海贫血(beta-thalassemia inter-media,β-TI)的抗体阳性发生率最高;女性抗体阳性发生率高于男性;年龄＞20岁患者的抗体阳性发生率最高.β-TM、β-TI、HbH患者中抗体阳性患者的年龄均明显高于抗体阴性患者(P＜0.05).β-TM患者中抗体阳性患者Hb水平低于抗体阴性患者(P＜0.05).地中海贫血抗体阳性患者Rh血型系统抗体及其合并其他抗体占73.92％(68/92),抗-Mur抗体及其合并其他抗体占8.70％(8/92),抗-JKa、抗-JKb抗体及其合并其他抗体占7.61％(7/92).结论 反复输血的广西地中海贫血患者,有较高的同种异体抗体阳性发生率,Rh血型系统抗体阳性最多.β-TI患者、汉族患者、女性患者和年龄大于20岁患者更易发生同种异体免疫反应.
Analysis of the Occurrence of Alloimmunization in Patients with Thalassemia in Guangxi
Objective To investigate the incidence of alloimmunization in patients with thalassemia undergoing long-term and repeated blood transfusions in Guangxi,and to identify specificity of antigen-specific alloantibodies,so as to improve blood transfusion strategies and patient's quality of life in clinical practice.Methods Based on the thalassemia management system,the data of 1115 patients with thalassemia who underwent blood transfusion in author's hospital from January 2017 to June 2022 were collected,and the incidence of positive antigen-specific alloantibodies was counted;the incidences of positive antigen-specific alloantibodies among different types of thalassemia,ethnicity,gender,age bracket and blood type were compared,the age and Hb level of different types of thalassemia antibody-positive and nega-tive patients were compared,and the antibody specificity of thalassemia antibody-positive patients was identified.Results Among the 1115 patients with thalassemia,92(8.25％)were positive for antibody screening.Compared with beta-thalassemia major(β-TM)and hemoglobin H disease(HbH),prevalence of antibody positivity of beta-thalassemia inter-media(β-TI)was the highest;female patients showed higher prevalence of antibody positivity than in male;the highest prevalence of antibody positivity was found in the age group＞20 years old.The age of antibody-positive patients in β-TM,β-TI and HbH patients was significantly higher than that of antibody-negative patients(P＜0.05).The Hb level of β-TM antibody-positive patients was lower than that of β-TM antibody-negative patients(P＜0.05).Rh blood group sys-tem antibody and its combined other antibodies accounted for 73.92％(68/92),anti-Mur antigen-specific alloantibodies accounted for 8.70％(8/92),and anti-JKa and anti-JKb antigen-specific alloantibodies accounted for 7.61％(7/92)in thalassemia antibody-positive patients.Conclusion There is a high positive rate of antigen-specific alloantibodies in thalassemia patients with repeated blood transfusions in Guangxi,especially in Rh blood group system.Patients with β-TI,Han ethnic,female and those over the age of 20 are more possible to develop alloimmunization.
ThalassemiaAntigen-specific al-loantibodiesAntibody identificationTransfusionRh blood group system
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