目的: 通过分析意外抗体筛查阳性患者的临床数据,探讨意外抗体的分布情况及其与输血史、妊娠史的相关性,为确保临床输血安全提供参考依据。方法: 本研究收集2020年4月至2021年3月中南大学湘雅三医院意外抗体筛查阳性患者及阴性患者的相关临床资料,单因素和多因素Logistic回归分析意外抗体产生的独立危险因素。结果: 在116名患者中,排除数据不全者后有66例意外抗体阳性患者,其中男性19例（28.79%）,女性47例（71.21%）。意外抗体主要分布在Rh系统（50%）,其中抗E最常见,占30.3%;Lewis血型系统占18.18%,部分患者同时出现抗Le^a与抗Le^b;MNS血型系统中抗M占13.64%、抗Mur抗体占9.09%。另外,自身抗体占3.03%、混合抗体占1.52%及未检出特异性抗体占1.52%。性别、输血史和妊娠史与意外抗体检出率均有统计学意义。此外,多因素Logistic回归分析显示,有输血史和有妊娠史是意外抗体产生的独立危险因素。结论: Rh血型系统中抗E的检出率最高,需引起重视。建议建立Rh血型系统献血者表型数据库,以便为患者提供更安全、快捷的输血治疗。

Objective This study aims to analyze clinical data collected from patients with positive accidental antibody screening results, exploring the distribution of accidental antibodies and their correlation with transfusion history and pregnancy history, providing a reference basis for ensuring clinical transfusion safety. Methods This research collected clinical data from patients with positive and negative accidental antibody screening results at Xiangya Third Hospital of Central South University from April 2020 to March 2021, and conducted a retrospective analysis. Results Among the 116 patients, 66 cases of accidental antibody positivity were identified after excluding incomplete data, including 19 males and 47 females. Accidental antibodies were mainly distributed in the Rh system, with anti-E being the most common, accounting for 30.3%; the Lewis blood group system accounted for 18.18%, with some patients exhibiting both anti-Lea and anti-Le^b; in the MNS blood group system, anti-M accounted for 13.64% and anti-Mur antibodies accounted for 9.09%. Additionally, autoantibodies accounted for 3.03%, mixed antibodies accounted for 1.52%, and specific antibodies not detected accounted for 1.52%. Gender, transfusion history, and pregnancy history were statistically significant factors in the detection rate of accidental antibodies. Furthermore, multivariable logistic regression analysis indicated that a history of transfusion and pregnancy were independent risk factors for the production of accidental antibodies. Conclusion The detection rate of anti-E in the Rh blood group system is the highest, which requires attention. It is recommended to establish a Rh blood group system donor phenotype database to provide safer and faster transfusion treatment for patients.