目的 探讨脑卒中患者多重耐药菌（MDROs）医院感染风险因素,并进行病原学特点分析。方法 选择2020年1月—2022年12月福建中医药大学附属福鼎医院神经内科病房收治的160例脑卒中患者为研究对象,评估患者的MDROs医院感染发生状况,调查患者的一般资料并进行多因素分析。结果 在160例患者中,发生医院感染20例,分离到病原体26株,其中8例样本为MDROs（研究组,其他归为对照组）,来源于8例患者,占比5.00%,包括耐甲氧西林金黄色葡萄球菌（MRSA）3株,耐碳青霉烯大肠埃希菌（E.coli）2株、耐碳青霉烯肺炎克雷伯菌（KP）1株、全耐药KP1株、耐碳青霉烯PA1株。研究组的美国国立卫生院神经功能缺损（NIHSS）评分、急性生理学和慢性健康状况评价Ⅱ（APACHEⅡ）评分、糖尿病、低蛋白血症、置管留置时间、住院时间等与对照组对比差异有统计学意义（P<0.05）。二分类Logistic回归分析显示,上述指标均为导致MDROs医院感染发生的重要因素（P<0.05）。结论 脑卒中患者MDROs医院感染的发生率依然比较高,病原菌多为耐甲氧西林MRSA、耐碳青霉烯E.coli,患者的NIHSS评分、APACHEⅡ评分、糖尿病、低蛋白血症、置管留置时间、住院时间为主要的MDROs感染风险因素。

目的 探讨柚皮素对人乳腺癌细胞株MCF-7和小鼠乳腺癌细胞系4T1的作用机制。方法 选择人乳腺癌细胞株MCF-7和小鼠乳腺癌细胞系4T1为实验对象,设置对照组和柚皮素组,其中柚皮素组分为20、40、80 和120 μmol/L 4个浓度,利用CCK-8、平板克隆形成实验检测柚皮素对乳腺癌细胞的增殖作用,应用流式细胞术检测柚皮素对乳腺癌细胞的凋亡作用。建立乳腺癌移植瘤模型,应用柚皮素作用于模型小鼠,探讨柚皮素在体内抗肿瘤作用。通过荧光定量PCR和蛋白免疫印迹实验检测自噬相关基因,分析其作用机制。结果 经柚皮素处理后,乳腺癌细胞的增殖明显受到抑制,正常乳腺癌细胞增殖情况变化不大,MCF-7乳腺癌细胞和小鼠乳腺癌4T1均出现明显的凋亡（P<0.001）。结论 柚皮素可以抑制乳腺癌细胞的增殖,且对正常乳腺细胞无明显毒副作用。柚皮素通过凋亡和自噬方式促进乳腺癌细胞的死亡,体内实验结果显示柚皮素具有抗肿瘤作用,并可促进其坏死。

目的 观察程序性死亡受体1（PD-1）联合细胞毒性T淋巴细胞相关蛋白4（CTLA-4）双免疫疗法对改善晚期乳腺癌近期疗效及远期预后的影响。方法 选择2020年5月—2022年5月商丘市第一人民医院收治的124例晚期乳腺癌患者为研究对象,经随机数字表法将其分为对照组（60例）和观察组（64例）,对照组予以常规PD-1单抗免疫疗法治疗,观察组采用PD-1联合CTLA-4双免疫疗法治疗,比较2组患者治疗前后肿瘤标志物水平、治疗后病灶缓解情况,对所有患者开展为期1年随访,统计并对比2组的不良反应发生情况及远期生存情况。结果 治疗前,2组患者的肿瘤标志物水平比较差异均无统计学意义（均P>0.05）;治疗后,观察组的癌胚抗原为（3.36±0.17）ng/mL,糖类抗原15-3为（25.33±5.28）U/mL,糖类抗原19-9为（38.77±5.62）U/mL,均低于对照组[（5.27±1.36）ng/mL、（28.44±5.18）U/mL、（41.25±5.46）U/mL,均P<0.05]。治疗后,观察组的完全缓解率为21.88%（14/64）,部分缓解率为31.25%（20/64）,病情稳定率为37.50%（24/64）,均高于对照组[8.33%（5/60）、13.33%（8/60）、23.33%（14/60）],肿瘤生长率为（30.27±5.18）%,肿瘤超进展率为6.25%（4/64）,均低于对照组[（33.49±5.32）%、18.33%（11/60）,均P<0.05]。治疗后,观察组的不良反应发生率为34.38%（22/64）,略高于对照组33.33%（20/60）,组间比较差异无统计学意义（P>0.05）;观察组的中位无进展生存期为（9.33±2.25）月,中位总生存期为（10.76±3.32）月,均高于对照组[（7.25±2.31）月、（7.41±1.62）月,均P<0.05]。结论 PD-1联合CTLA-4双免疫疗法能有效改善晚期乳腺癌的近期疗效及远期预后,此疗法未明显增加不良反应发生风险,安全性高。

Objective To observe the effect of programmed cell death protein-1（PD-1）combined with cytotoxic T lymphocyte-associated antigen-4（CTLA-4）dual immunotherapy on the short-term efficacy and long-term prognosis of advanced breast cancer．Methods A total of 124 patients with advanced breast cancer who were admitted to the First People's Hospital of Shangqiu City from May 2020 to May 2022 were selected as the research objects．They were randomly divided into the control group（60 cases）and the observation group（64 cases）by the method of random number table．The control group was treated with conventional PD-1 monoclonal antibody immunotherapy,and the observation group was treated with PD-1 combined with CTLA-4 double immunotherapy．The levels of tumor markers before and after treatment and the focal remission after treatment were compared between the two groups．All patients were followed up for one year,the incidence of adverse reactions and long-term survival between the two groups were compared．Results Before treatment,there was no statistically significant difference in the levels of tumor markers between two groups（all P>0.05）．After treatment,the carcino-embryonic antigen content of the observation group was（3.36±0.17）ng/mL,CA153 was（25.33±5.28）U/mL,and CA199 was（38.77±5.62）U/mL,which were lower than those of the control group [（5.27±1.36）ng/mL,（28.44±5.18）U/mL,（41.25±5.46）U/mL,all P<0.05]．After treatment,the complete remission rate of the observation group was 21.88%（14/64）,partial remission rate was 31.25%（20/64）,and stable disease rate was 37.50%（24/64）,all higher than those of the control group [8.33%（5/60）,13.33%（8/60）,23.33%（14/60）];tumor growth rate of the observation group was（30.27±5.18）%,hyper progressive disease rate was 6.25%（4/64）,both lower than those of the control group [（33.49±5.32）%,18.33%（11/60）,both P<0.05]．After treatment,the incidence of adverse reactions in the observation group was 34.38%（22/64）,slightly higher than that in the control group 33.33%（20/60）（P>0.05）．The median progression free survival of the observation group was（9.33±2.25）months,and the median overall survival was（10.76±3.32）months,both higher than those of the control group [（7.25±2.31）months and（7.41±1.62）months]（P<0.05）．Conclusions PD-1 combined with CTLA-4 dual immunotherapy can effectively improve the short-term efficacy and long-term prognosis of advanced breast cancer．This therapy does not significantly increase the risk of side effects,which is safe．

目的 观察改良直接抽吸取栓术（ADAPT）治疗急性前循环大动脉栓塞性脑卒中的有效性与安全性。方法 回顾性分析2022年3月—2023年2月在广州市第一人民医院采用改良ADAPT治疗急性前循环大动脉栓塞性脑卒中的12例患者临床资料。该改良技术核心是血栓抽吸导管或颅内支持导管管头明确越过血栓后才开始直接使用20 mL的注射器进行手动持续抽吸;所有患者术后依据临床症状和影像表现启动规范抗凝药物治疗,每月门诊随访观察有无再发卒中。结果 12例患者闭塞血管均成功再通,其中改良脑梗死溶栓（mTICI ）2b~2c级3例（25%）,mTICI 3级9例（75%）;从穿刺到血管再通平均时间为37.7 min,首次取栓再通8例（66.7%）,其中颈内动脉闭塞首次取栓再通成功率达80%,出院时平均美国国立卫生研究院卒中量表（NIHSS）评分（9.00±9.22）分,与术前基础NIHSS评分相比,平均下降7分,术后90 d功能恢复良好（mRS评分0~2分）9例（75%）;术后脑出血3例（25%）,其中1例为小点状出血（HI1）而无明显症状、1例为血肿<梗死面积的30%并有轻微占位效应的出血（PH1）恢复良好、1例为血肿>梗死面积的30%并有明显占位效应的出血（PH2）术后自动出院,12例患者筛查病因均发现有心房纤颤,9例患者术后依据临床症状和影像表现在早期开展规范抗凝二级预防管理后无再复发。结论 改良ADAPT是治疗急性大动脉栓塞性脑卒中的一种安全可行选择,血管再通效率高,血栓逃逸概率低、临床疗效良好。对心房纤颤患者实施规范抗凝管理可有效预防脑卒中复发。

Objective To observe the efficacy and safety of modified-a direct aspiration first-pass technique（ADAPT）in the treatment of acute anterior circulation aorta embolic stroke．Methods The clinical data of 12 patients with acute anterior circulation arterial embolic stroke treated by modified-ADAPT in our hospital from March 2022 to February 2023 were analyzed retrospectively．The core of the modified technique is that the head of the thrombus aspiration catheter or intracranial support catheter clearly crosses the thrombus before manual continuous suction with a 20 mL syringe．After operation,all patients started standard anticoagulant therapy according to clinical symptoms and imaging manifestations,and monthly outpatient follow-up was conducted to observe whether there was recurrent stroke．Results Occlusive vessels were successfully recanalized in 12 patients,including 3 cases（25%）of mTICI 2b-2c grade and 9 cases（75%）of mTICI 3 grade．The average time from puncture to vascular recanalization was 37.7 min,and the first thrombectomy and recanalization was performed in 8 cases（66.7%）．The success rate of internal carotid artery occlusion was 80%．The average NIHSSS score at discharge was（9.00±9.22）．Compared with the preoperative NIHSS score,the average score decreased by 7 points．90 days after operation,the function recovered well in 9 cases（75%）．Postoperative cerebral hemorrhage occurred in 3 cases（25%）,including 1 case of punctate hemorrhage without obvious symptoms,1 case of good recovery of PH1 and 1 case of automatic discharge after PH2．12 patients were found to have atrial fibrillation after screening,9 patients had no recurrence after anticoagulation secondary prevention management according to clinical symptoms and imaging manifestations．Conclusions Modified-ADAPT is a safe and feasible choice for the treatment of acute arterial embolism stroke,with high recanalization efficiency,low thrombus escape probability and good clinical effect．Standardized anticoagulation management can effectively prevent the recurrence of stroke in patients with atrial fibrillation．

目的 探讨子宫内膜癌构成及临床病理特征。方法 以南平市第一医院2020年1月—2022年6月期间收治的82例子宫内膜癌患者为研究对象,收集其临床资料,通过免疫组织化学染色法检测4种错配修复蛋白表达,并分析错配修复蛋白表达与临床病理特征的关系。结果 82例患者中,70例（85.37%）为子宫内膜样癌,病理组织学类型以G1级30例（42.86%）为主,其他类型较为少见。错配修复蛋白表达总缺失率为35.71%,其中MUTL同源物1（MLH1）单独缺失率为2.86%,错配修复蛋白2抗体（MSH2）为4.29%,错配修复蛋白6抗体（MSH6）为14.29%,肿瘤错配修复基因PMS2抗体（PMS2）为14.29%;错配修复表达缺失（dMMR）组患者年龄50岁以上、伴脉管侵犯和淋巴结转移、组织学G3级和FIGO分期Ⅲ期占比高于错配修复表达正常（pMMR）组患者（P<0.05）;MSH6蛋白表达缺失易发生在年龄50岁以上、有家族相关疾病史的患者（P<0.05）;PMS2蛋白表达缺失易发生在组织学G2级、FIGO分期Ⅲ期、妊娠1次及以上、脉管内癌栓和淋巴结转移的患者（P<0.05）。结论 子宫内膜癌错配修复蛋白表达与其部分临床病理特征存在密切关联,可为患者后续治疗提供有价值的指导。

Objective To investigate the composition and clinicopathological features of endometrial carcinoma．Methods A total of 82 cases of endometrial carcinoma patients admitted to the First Hospital of Nanping City from January 2020 to June 2022 were studied．Epidemiological data were collected,and the expression of 4 mismatch repair proteins were detected by immunohistochemical staining,and their relationship with clinicopathological features was analyzed．Results Among 82 patients,70 cases（85.37%）were endometrioid carcinoma,and 30 cases（42.86%）were mainly G1 grade,other types were rare．The total deletion rate of mismatch repair proteins expression was 35.71%,in which MLH1 alone was 2.86%,MSH2 was 4.29%,MSH6 was14.29% and PMS2 was14.29%．The proportions of dMMR patients over 50 years old,with vascular invasion and lymph node metastasis,G3 grade histology and FIGO stage Ⅲ were significantly higher than those of the pMMR group（P<0.05）．The loss of MSH6 protein expression was more likely to occur in patients over 50 years old with a family history of related diseases（P<0.05）．The deletion of PMS2 protein expression was more likely to occur in patients with histological G2 grade,FIGO stage III,pregnancy of once or more and intravascular cancer thrombin and lymph node metastasis（P<0.05）．Conclusions The expression of mismatch repair proteins in endometrial carcinoma is closely related to some clinicopathological features,which provides valuable guidance for follow-up treatment．

目的 探讨绝经后2型糖尿病人群性激素水平与体质指数（BMI）的关系。方法 收集2022年1月—2023年1月在我院住院的2型糖尿病患者,随机选取自然绝经后女性184例,根据其BMI分组,其中肥胖组23例、超重组74例、BMI正常组87例,比较3组间临床资料及性激素差异。结果 3组间腰围、空腹血糖（FPG）、甘油三酯、高密度脂蛋白胆固醇、血尿酸、卵泡刺激素（FSH）、黄体生成素（LH）、雌激素（E₂）比较差异均有统计学意义（均P<0.05）,肥胖组和超重组的E₂高于正常组,FSH及LH低于正常组。3组间年龄、糖化血红蛋白、收缩压、舒张压、总胆固醇、低密度脂蛋白胆固醇、催乳素、睾酮、孕酮比较差异均无统计学意义（均P>0.05）。Logistic回归分析显示,过高的腰围和较低的FSH、LH是绝经后2型糖尿病女性肥胖的影响因素。结论 2型糖尿病绝经后女性应控制腹型肥胖,定期复查LH、FSH,提早干预。

Objective To investigate the relationship between sex hormone levels and body mass index（BMI）in postmenopausal women with type 2 diabetes mellitus（T2DM）．Methods A total of 184 cases of natural postmenopausal women with T2DM admitted to our hospital from January 2022 to January 2023 were randomly selected,including 23 cases of obesity,74 cases of over weight and 87 cases of normal BMI．The clinical data and sex hormones among the three groups were analyzed．Results Waist circumference,fasting plasma glucose（FPG）,triglyceride,high density lipoprotein cholesterol,uric acid,follicle-stimulating hormone（FSH）,luteinizing hormone（LH）and oestrogen（E₂）levels were significantly different among the three groups（P<0.05）．E₂ levels of the obesity group and the over weight group were significantly higher than that of the normal group,while FSH and LH levels were significantly lower than that of the normal group．There was no significant difference in age,hemoglobin A1c,systolic blood pressure,diastolic blood pressure,total cholesterol,low density lipoprotein cholesterol,prolactin,testosterone and progesterone levels among the three groups（P>0.05）．Logistic regression analysis showed that higher waist circumference and lower FSH and LH levels were significantly correlated with obesity in postmenopausal women with T2DM．Conclusions Abdominal obesity should be controlled in postmenopausal women with T2DM,and LH and FSH should be periodically reviewed,in order to treat in advance．

目的 评估内镜下切开联合丝裂霉素C注射治疗复发性食管良性狭窄的疗效和安全性。方法 对2021年6月—2022年5月在厦门大学附属中山医院消化内科接受内镜下切开联合或不联合丝裂霉素C注射的43例复发性食管良性狭窄患者进行回顾性分析,分为切开组与切开联合丝裂霉素C注射组,对比2组间狭窄缓解率、并发症及预防狭窄复发的效果。结果 2组患者均顺利完成治疗,无严重并发症发生。2组患者治疗后狭窄缓解率无显著差异（P>0.05）。随访12个月,切开联合丝裂霉素C注射组在狭窄缓解时长、狭窄复发再次扩张次数及扩张间隔均优于切开组（P<0.05）。结论 内镜下切开联合丝裂霉素C注射治疗安全、有效,虽然治疗后狭窄缓解率与单纯切开无显著差异,但可延长狭窄缓解期,改善狭窄复发后重复扩张的频率及间隔时间。

Objective To evaluate the efficacy and safety of endoscopic incision combined with mitomycin C injection in the treatment of recurrent benign esophageal stenosis．Methods A retrospective analysis was conducted on 43 patients with recurrent benign esophageal stenosis who received endoscopic incision combined with or without mitomycin C injection in the Department of Gastroenterology,Zhongshan Hospital of Xiamen University from June 2021 to May 2022．Patients were divided into incision group and incision combined with mitomycin C injection group．The stenosis remission rate,complications and preventive effect of stenosis recurrence were compared between the two groups．Results All patients in the two groups successfully completed the treatment without serious complications．There was no significant difference in the stenosis remission rate between the two groups after treatment（P>0.05）．In the follow-up 12 months after treatment,incision combined with mitomycin C injection group was better than incision group in the duration of stenosis remission,the number of stenosis recurrence and dilation interval（P<0.05）．Conclusions Endoscopic incision combined with mitomycin C injection is safe and effective．Although the remission rate of stenosis after treatment is not significantly different from that of incision alone,it can prolong the remission period of stenosis and improve the frequency and interval of repeated dilation after stenosis recurrence．

目的 探索实体肿瘤内部不同区域的间质液压（IFP）分布的异质性。方法 通过建立新西兰大白兔的皮下浅肌层VX2移植瘤模型,通过超声造影观察肿瘤的大小、形状、血流灌注等成瘤情况,并在超声引导下通过针芯法（WIN法）测量41只荷瘤兔VX2移植瘤内部不同区域的IFP。结果 41只荷瘤兔的VX2移植瘤的中央IFP为（23.79±8.07） mmHg、肿瘤外周1/2IFP为（15.58±5.22）mmHg、肿瘤外周1/4IFP为（8.29±5.47）mmHg,IFP从中央到外周逐步降低（F=70.85,P<0.001）。结论 VX2移植瘤内不同区域的IFP存在异质性,即从中央到外周IFP呈梯度显著降低。

Objective To explore the heterogeneity of interstitial fluid pressure（IFP）distribution in different regions of solid tumors．Methods The model of VX2 tumor was established in New Zealand white rabbits．The size,shape and blood perfusion of the tumor were observed by contrast-enhanced ultrasound,the IFP of VX2 tumor in 41 rabbits was measured by the wick-in-needle method（WIN method）under the guidance of ultrasound．Results The mean values of central IFP,peripheral 1/2 IFP and peripheral 1/4 IFP were（23.79±8.07） mmHg,（15.58±5.22 ）mmHg and （8.29±5.47） mmHg,respectively by statistical analysis,the IFP values changed significantly with different regions（F=70.85,P<0.001）．Conclusions There is heterogeneity of IFP in different regions of VX2 xenografts,that is,from the center to the periphery,the IFP decreased significantly．

目的 探索整体针联合运动处方应用于伴骨质疏松症（OP）的膝骨关节炎（KOA）患者全膝关节置换术（TKA）术前预康复的可行性、有效性及其对Wnt/β-catenin通路的影响。方法 2021年5月—2022年4月在广州市第一人民医院南沙医院骨科住院治疗的伴OP的KOA患者随机入组,分3组：A组予常规术前宣教和准备;B组在A组基础上,术前应用标准化运动处方3周;C组在A组基础上,术前联合应用整体针和运动处方3周。比较术前3周、术前1天、术后8周视觉模拟疼痛评分（VAS）、关节活动度（ROM）、膝关节功能评分（HSS）的组间差异,并比较术中关节液β连环蛋白（β-catenin）、基质金属蛋白酶-13（MMP-13）、重组人Dickkopf相关蛋白-1（DKK-1）含量的组间差异。结果 共纳入50例受试者,A组15例,B组18例,C组17例。术前1天组间方差分析显示：B、C组VAS均低于A组（P<0.05）,C组VAS低于B组（P<0.05）;B、C组ROM均高于A组（P<0.05）,B、C组ROM比较差异无统计学意义（P>0.05）;B、C组HSS均高于A组（P<0.05）,C组HSS高于B组（P<0.05）。术后8周组间方差分析显示：B、C组VAS均低于A组（P<0.05）,C组VAS低于B组（P<0.05）;B、C组ROM均高于A组（P<0.05）,B、C组ROM比较差异无统计学意义（P>0.05）;B、C组HSS均高于A组（P<0.05）,C组HSS高于B组（P<0.05）。术中关节液标志物含量组间方差分析显示：B、C组β-catenin、MMP-13含量均低于A组（P<0.05）,C组β-catenin、MMP-13含量均低于B组（均P<0.05）;B、C组DKK-1含量均高于A组（均P<0.05）,C组DKK-1含量高于B组（P<0.05）。结论 整体针联合运动处方在OP患者TKA术前应用切实可行,可有效缓解疼痛、改善功能。整体针可增强运动处方的正向预康复作用,其作用机制可能与Wnt/β-catenin通路调节有关。

Objective To explore the feasibility,effectiveness and impact on the Wnt/β-catenin pathway of combined holistic acupuncture and exercise prescription for preoperative rehabilitation in knee osteoarthritis（KOA）patients with osteoporosis（OP）undergoing total knee arthroplasty（TKA）．Methods KOA patients with OP were divided into three groups randomly：Group A received conventional preoperative education and preparation,Group B received standardized exercise prescription for three weeks additionally,Group C received combined holistic acupuncture and exercise prescription for three weeks additionally．Between-group differences in visual analogue scale（VAS）pain scores,range of motion（ROM）and knee joint function scores（HSS）were compared at 3 weeks preoperatively,1 day preoperatively and 8 weeks postoperatively．Differences in intraoperative joint fluid levels of β-catenin,MMP-13 and DKK-1 were also compared．Results A total of 50 participants were included,with 15 in Group A,18 in Group B and 17 in Group C．Baseline conditions were comparable among the three groups．One-day preoperative analysis showed that VAS scores were lower in both Groups B and C compared to Group A（P<0.05）,and VAS score was lower in Group C compared to Group B（P<0.05）．ROM was higher in Groups B and C compared to Group A（P<0.05）,with no statistically significant between-group difference between Groups B and C．HSS scores were higher in Groups B and C compared to Group A（P<0.05）,and HSS score was higher in Group C compared to Group B（P<0.05）．Eight-week postoperative analysis revealed that VAS scores were lower in both Groups B and C compared to Group A（P<0.05）,and VAS score was lower in Group C compared to Group B（P<0.05）．ROM were higher in Groups B and C compared to Group A（P<0.05）,with no statistically significant between-group difference between Group B and C．HSS scores were higher in Groups B and C compared to Group A（P<0.05）,and HSS score was higher in Group C compared to Group B（P<0.05）．Intraoperative joint fluid biomarker analysis showed that β-catenin and MMP-13 levels were lower in Groups B and C compared to Group A（P<0.05）,and β-catenin and MMP-13 levels were lower in Group C compared to Group B（P<0.05）．DKK-1 levels were higher in Groups B and C compared to Group A（P<0.05）,and DKK-1 level was higher in Group C compared to Group B（P<0.05）．Conclusions Combined holistic acupuncture and exercise prescription is feasible and effective for preoperative rehabilitation in TKA for KOA patients with OP．Holistic acupuncture enhances the positive pre-rehabilitation effect of exercise prescription,and its mechanism may be related to the regulation of the Wnt/β-catenin pathway．

目的 研究抗体筛查阳性输血患者的抗体与Rh抗原分布情况。方法 收集2019年10月1日—2022年12月31日中山大学孙逸仙纪念医院34 796例患者的不规则抗体筛查结果,以及抗体筛查阳性患者的抗体鉴定与Rh抗原分型结果,记录34 796例患者的年龄、性别、妊娠史、输血史等基本资料,分析各血型系统不规则抗体产生的阳性率及相关影响因素。结果 34 796例患者中,不规则抗体筛查阳性的患者237例,抗体筛查阳性率为0.68%。共检出不规则抗体260例,其中MNS系统83例（占31.93%）,Rh血型系统抗体70例（占26.93%）,Lewis血型系统14例（占比5.39%）。同种非特异性抗体79例,阳性率30.38%。同种特异性抗体中抗-E的占比最高,为20.77%;其次是抗-Mia,为20.39%。对237例抗体筛查阳性患者进行Rh抗原分型,CCDee抗原表型占比最高,为52.74%,其次是CcDEe占比29.16%。抗体筛查阳性率与性别、输血史、妊娠史有关,女性、有输血史、有妊娠史者的抗体筛查阳性率较高（P>0.05）。不同科室间抗体筛查阳性率比较差异有统计学意义（P>0.05）,其中风湿免疫科与血液科患者阳性率最高。结论 抗-E、抗-Mia为主要的红细胞不规则抗体,不规则抗体的产生与性别、输血史、妊娠史有关,输血前进行不规则抗体筛查、鉴定及Rh抗原分型,有利于提高输血安全。

Objective To explore the distribution of antibodies and Rh antigens in transfusion patients with positive antibodies screened in our hospital．Methods From October 1,2019 to December 31,2022,there were 34,796 patients undergoing irregular antibody screening in Sun Yat-sen Memorial Hospital of Sun Yat-sen University,antibody identification and Rh blood typing results of positive patients were collected．Meanwhile,the age,sex,pregnancy history,blood transfusion history and other basic data of 34 796 patients were collected,and the positive rate of irregular antibody production and related influencing factors of blood group system were analyzed．Results Among the 34,796 patients,237 patients were screened positive for irregular antibodies,and the antibody screening positivity rate was 0.68%．A total of 260 cases of irregular antibodies were detected,83 cases of MNS system,accounting for 31.93%;70 cases of Rh blood group system,accounting for 26.93%;14 cases of Lewis blood group system,accounting for 5.39%．There were 79 cases of homozygous non-specific antibodies,with a detection rate of 30.38%．The highest percentage of homo-specific antibodies was anti-E,accounting for 20.77%,followed by anti-Mia,accounting for 20.39%．Rh antigen typing was performed in 237 antibody-screening positive patients,and the highest percentage of CCDee antigen phenotype was 52.74%,followed by CcDEe with 29.16%．Antibody screening positive rate was correlated with gender,blood transfusion history and pregnancy history,and the positive rate was higher in female,patients with blood transfusion history and pregnancy history,and the difference was statistically significant（P>0.05）．There were differences in the positive detection rate of antibody-screening in different departments,and the differences were statistically significant（P>0.05）,and the highest positive rates were in Department of Rheumatology and Immunology and Hematology．Conclusions Anti-E,anti-Mia are the main erythrocyte irregular antibodies,and the production of irregular antibodies is related to gender,transfusion history and pregnancy history,and irregular antibody screening,identification and Rh antigen typing before transfusion are beneficial to improve transfusion safety．