中国输血杂志2025，Vol.38Issue(8)：1063-1070,8.DOI:10.13303/j.cjbt.issn.1004-549x.2025.08.010
不同次数疑难交叉配血患者的意外抗体分布与临床特征差异
Disparities in unexpected antibody distribution and clinical features by frequency of cross-matching incompatibility
摘要
Abstract
Objective To investigate the clinical characteristics,the types of unexpected antibodies,and their impacts on immunological risks among patients with different frequencies of cross-matching incompatibility,so as to propose corre-sponding solutions.Methods Data of cross-matching incompatibility samples from 92 medical institutions during 2022 to 2024 were collected and divided into three groups based on the frequency of cross-matching.Statistical analysis was per-formed on disease types,distribution of hematologic diseases,alloantibody detection rates,and proportions of alloantibody types.Results The 858 patients were divided into three groups based on the frequency of blood cross-matching incompati-bility:≥5 times(8.28%,71/858),2 to 4 times(28.21%,242/858);1 time(63.52%,545/858).There was a clus-tered distribution of disease types in the≥5 cross-matchings group,with 71.83%(51/71)of patients having tumors or he-matologic and hematopoietic diseases.In contrast,the disease types in the 2 to 4 cross-matchings and 1 cross-matching groups were more diverse.An analysis of 249 patients with hematologic diseases found that multiple myeloma was the most common disease in all three groups,accounting for 31.43%(11/35),35.37%(29/82),and 37.88%(50/132)respec-tively.In the≥5 cross-matchings group,myelodysplastic syndrome(14.29%,5/35)and thalassemia(14.29%,5/35)were the second most common diseases.In contrast,in the 2 to 4 cross-matchings group and 1 cross-matching group,auto-immune hemolytic anemia was the second most common disease,with prevalence rates of 20.73%(17/82)and 24.24%(32/132),respectively.Alloantibodies were detected in 54.66%of the patients,with antibodies against Rh blood group being most frequent(>50%)in all three groups.The detection rates of alloantibodies/alloantibodies with coexisting au-toantibodies decreased across groups:the≥5 cross-matchings group(70.42%,50/71)>the 2 to 4 cross-matchings group(54.96%,133/242)>the 1 cross-matching group(52.48%,286/545).Conclusion The risk of alloantibody produc-tion increases in patients with multiple cross-matching incompatibilities,especially in those with tumors or hematologic dis-eases.For handling of cross-matching incompatibility cases,it is recommended to optimize the cross-matching process,im-plement individualized transfusion plans,and enhance the technical capabilities of clinical transfusion departments and blood group reference laboratories to ensure the safety and effectiveness of transfusions.关键词
交叉配血/同种抗体/自身抗体/输血安全Key words
cross-matching/alloantibodies/autoantibodies/transfusion safety分类
医药卫生引用本文复制引用
崔丹荔,刘不尽,邹海曼,尹鹏为,卿芸,代华友,吴思其,杨俊鸿,黄霞..不同次数疑难交叉配血患者的意外抗体分布与临床特征差异[J].中国输血杂志,2025,38(8):1063-1070,8.基金项目
重庆市九龙坡区2024年度科技计划项目(科卫联合)(2024-04-021-Y)、重庆市科卫联合医学科研项目(2024MSXM169) （科卫联合）
