摘要
目的分析血液病对输血前检查中抗体检测的影响,选择合理的ABO血型鉴定、抗体筛选和交叉配血方法。方法对2012年7月至2014年2月422例临床确诊为血液病并送本室进行疑难定型和交叉配血的患者血液标本,进行ABO血型鉴定、抗体筛选和鉴定及交叉配血,采用血型血清学方法及PCR-SSP血型基因检测鉴定ABO血型。采用盐水法、LISS-IAT法(微柱凝集)、经典-IAT法进行抗体筛选和鉴定及交叉配血。结果 422例患者中,127例(30.09%)试管法正反定型相符,可确定ABO血型;74例(17.54%)抗原减弱;221例(52.37%)反定型抗体减弱或异常,其中自身免疫性溶血性贫血(AIHA)75例(33.94%),多发性骨髓瘤(MM)72例(32.58%),其余为骨髓增生异常综合征(MDS)、再生障碍性贫血(AA)、急性淋巴细胞白血病(ALL)、淋巴瘤患者。这221例患者中,存在同种抗体37例,自身抗体65例,同种+自身抗体9例。结论血液病影响输血前检查中的抗体检测。ABO抗体减弱或异常最常见于AIHA和MM;血液病患者常因输血产生同种抗体,且很多患者体内存在自身抗体,应根据抗体检测的结果选择合适的交叉配血方法,保障输血安全。
Objective To analyze the influence of hematological diseases on pre-transfusion antibody testing, and identify reasonable method for ABO blood grouping, antibody screening and cross-matching test accordingly. Methods From July 2012 to February 2014, pre-transfusion test including blood grouping, antibody screening and identification and cross matching test were performed in 422 patients with definitely diagnosed hematological diseases. Routine serologic typ-ing was performed in all 422 samples, and genotyping was carried out by PCR-SSP technique with weakened ABO ex-pression in order to clarify ABO blood type;tube saline method, LISS-IAT method（column agglutination）, classical IAT test was adopted for antibody screening and cross-matching. Results Among the 422 samples, 127 samples（30.09%） were de-termined ABO type via tube test; 74 samples （17.54%） were detected weakened ABO antigen expression; 221 samples （52.37%） were identified with weak or abnormal antibody level when performing reverse ABO grouping. Among these 221 patients, 75（33.94%） were autoimmune hemolytic anemia（AIHA）, 72（32.58%） were multiple myeloid（MM）, and the rest were patients with MDS, AA, ALL or lymphoma. Among 221 patients, allo-antibody was identified in serum of 37 patients, and auto-antibody in 65 patients. Allo-antibody and auto-antibody simultaneously existed in 9 patients. Conclusion Hemato-logical diseases could influence antibody testing. Weakened or abnormal ABO antibody level most often occurs in patients with AIHA and MM. Allo-antibody existed in patients with hematological diseases because of frequent blood transfusion, and auto-antibody often existed in many patients. Reasonable method for cross-matching should be choosed in order to as-sure safety of blood transfusion.
出处
《北京医学》
CAS
2014年第8期685-688,共4页
Beijing Medical Journal
关键词
ABO血型
同种抗体
自身抗体
临床输血
ABO blood type Allo-antibody Auto-antibody Clinical transfusion
