摘要
目的探讨自身免疫性溶血性贫血(AIHA)对输血前检查3项的影响,建立AIHA患者血液标本的研究性实验方法及交叉配血策略。方法对392份AIHA患者血液标本进行血型鉴定、抗体筛选和鉴定、DAT分型及交叉配血试验,结合患者的临床诊断、治疗及免疫史,分析试验结果并选择盐水介质直接离心法、LISS/Coombs卡、经典抗人球蛋白试验等不同方法进行抗体筛选、鉴定及交叉配血。结果 392份AIHA标本中338份(86.2%)为温自身抗体,17份(4.3%)为冷自身抗体,37份(9.4%)为混合型自身抗体(温+冷自身抗体),其中45份同时存在同种抗体;48份自身抗体具有类特异性,344份自身抗体无特异性(全凝集素);交叉配血方法选择LISS/Coombs卡相合21份,试管法LISS-IAT相合22份,经典抗人球蛋白法相合218份,配血均不相合153份。结论对于AIHA患者血液标本应建立完整的输血前检查试验方法,根据试验结果选择适合的交叉配血方法,保障临床输血的及时、安全和有效性。
Objective To develop pre-transfusion test procedure for autoimmune hemolytic anemia （AIHA） testing. Methods Pre-transfusion tests were done for 392 cases with AIHA. The testing methods included blood grouping, irregu- lar antibody screening and identification, compatibility test and direct anti-human globulin test. By analyzing the clinical diagnoses, histories of therapy, and the pre-transfusion test results, suitable method for cross-matching test, such as saline immediate spin method, classic saline indirect anti-human globulin test（IAT）, LISS/Coombs card IAT were chosen. Results In 392 AIHA blood cases, 338（86.2%） had warm auto-antibodies, 17（4.3%） had cold auto-antibodies, 37（9.4%） had both warm and cold auto-antibodies. In 392 AIHA blood cases, 45 had both auto and alloantibody, 48 had specific auto-anti-bodies, 344 had auto-antibodies without specificity. The blood cross-matching found that 21 cases were LISS/Coombs card compatible, 22 were LISS-IAT tube test compatible, 218 were IAT compatible, 153 were incompatible. Conclusion All-inclusive pre-transfusion test methods should be set up for the blood samples in case of AIHA. According to the test results, perfect compatibility test procedures should be chosen to ensure timely, safe and effective clinical transfusion.
出处
《北京医学》
CAS
2013年第8期717-720,共4页
Beijing Medical Journal
关键词
自身免疫性溶血性贫血
输血前检查
自身抗体
同种抗体
抗体筛选和鉴定
交叉配血
Autoimmune hemolytic anemia （AIHA）
Pre-transfusion test
Autoantibody
Alloantibody
An-tibody detecting and identifying
Blood cross-matching
