摘要:
Objective:To study the positive distribution rate of Coombs test in patients with clinical anemia and blood transfusion,and its effect on clinical blood transfusion.Methods:Seventy patients with hemoglobin level in the normal range were enrolled into control group,while 130 patients with anemia or blood transfusion who's hemoglobin level was lower comfirmed by micro-column gel antihuman globin detection card and 70 surgical patients with anemia or blood transfusion who's hemoglobin level was lower comfirmed by micro-column gel anti-human globin card were enrolled into anemia or blood transfusion (A or BT) group.And coomb's test performed for all the patients,in which the positive patients in Department of Internal Medicine need to be re-typed.Results:Among 70 surgical patients with anemia or blood transfusion,14 cases were directly detected to be anti-human globine positive with detection rate 20%;among 130 internal medicine patients with anemia or blood transfusion,54 cases were directly detected to be anti-human globine positive with detection rate 41.4%.Among 270 cases,the highest positive rate (66.7%) was observed in patients with 50-59 g/L of hemoglobin.According to type test,the samples of 54 patients with anemia in Department of Internal Medicine,who were directly selected to be anti-human globin positive,could be divided into anti-C3d(7 cases,accounting for 13.0%),anti-IgG(12 cases accounting for,22.2%) and anti-C3d + anti-IgG (35 cases,accounting for 64.8%),while according to diseases,the anti-human globin positive ratio was high in tumor cancer,hephropathy and gastroenteropathy patients,and patients in intensive care unit,moreover the blood transfusion frequency of these patients was higher than that of patients with anti-human globin negative (P < 0.05).Conclusion:The important causes affecting the anemia in patients may relate with direct anti-human globulin positive test,therefore the interference of direct anti-human globin positive should be excluded in the course of blood transfusion,so as to ensure the effectiveness of blood transfusion.%目的:研究直接抗人球蛋白试验(Coombs试验)在临床贫血和输血患者中的阳性分布率.方法:随机选取本院2014-2016年70例经微柱凝胶抗人球蛋白检测卡检测血红蛋白含量在正常范围内者做为对照组,130例经微柱凝胶抗人球蛋白检测卡检测为血红蛋白含量较低的内科贫血患者或者输血患者、以及70例经微柱凝胶抗人球蛋白检测卡检测为血红蛋白含量较低的外科贫血患者或者输血患者为观察组,并对所有患者进行Coombs试验,其中对直接被检出阳性的内科患者需再行分型试验.结果:外科贫血患者或者输血患者中有14例被直接检出抗人球蛋白阳性,其抗人球蛋白直接检出率为20.0%;内科贫血患者或者输血患者中有54例被直接检出抗人球蛋白阳性,其抗人球蛋白直接检出率为41.4%.在270例中血红蛋白含量分布在50-59g/L的阳性率最高,占59.8%.54例被直接检出抗人球蛋白阳性的内科贫血患者的标本按分型试验可分为抗-C3d 7例,占13.0%;抗-IgG 12例,占22.2%;抗-C3d+抗-IgG 35例,占64.8%;54例被直接检出抗人球蛋白阳性的内科贫血患者按科室分布,其中以消化内科、肿瘤科、肾病科、胃肠病和ICU所占的比例最高,且这类患者的输血频率也较阴性患者高(P<0.05).结论:影响患者贫血的重要原因可能与直接抗人球蛋白试验阳性有关,因此在患者的输血治疗过程中应该注意到要排除直接抗人球蛋白试验阳性的干扰,以保证输血的有效进行.