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16例冷凝集素造成的血型不合分析 被引量:11

Blood type incompatibility caused by cold agglutination: A study of 16 cases
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摘要 目的探讨冷凝集素对血型造成的影响及相应的处理效果。方法采用37℃水浴、吸收放散试验及2-巯基乙醇等方法消除冷凝集素的影响,并对处理后的红细胞和血清进行正反定型、交叉配血、直接抗人球蛋白实验及间接抗人球蛋白实验等实验。结果 16例患者标本在处理前均呈明显的正反定型不符,交叉配血困难,经鉴定均由冷凝集素造成。经过相应处理后,所有标本正反定型、交叉配血及抗体筛选均相符或呈阴性,患者输注交叉配血相合血液成分均未发生输血反应,血红蛋白上升符合输注有效标准。结论对于明确由冷凝集素引起的正反定型不符或交叉配血不合的标本,经过37℃水浴、吸收放散试验及2-巯基乙醇处理后,可以消除冷凝集素带来的干扰,获得正确的实验结果,其中AIHA的病人表现出的不同于其他病例的冷凝集素的强反应性更值得我们的关注。 Objective To investigate the effect of cold agglutination on blood group typing. Methods 37℃ water bath, absorption elution test and 2-mercaptoethanol method were used to eliminate the influence of cold agglutination. Forward and reverse blood group typing, cross matching, DAT and IAT experiments were then performed on red blood cells and serum after treatment. Results Before treatment, obvious discrepancy in forward/reverse typing and nontypable cross matching in 16 blood samples were noticed due to cold agglutination. After corresponding treatments, all samples were consistent or negative in forward/reverse typing, cross matching and antibody screening. No adverse reactions to cross matching blood transfusion occurred in patients, and the increase of hemoglobin was in line with the effective standard of transfusion. Conclusion 37℃ water bath, absorption elution test and 2-mercaptoethanol method can be used to eliminate the interference caused by cold agglutination to obtain correct typing results. The strong reactivity caused by cold agglutination in AIHA patients were different from other cases, which deserved our attention.
作者 谢惠益 周载鑫 顾海慧 钱宝华 XIE Huiyi;ZHOU Zaixin;GU Haihui;QIAN Baohua(Department of Transfusion Medicine,Changhai Hospital,Shanghai 200433,China)
出处 《中国输血杂志》 CAS 2021年第1期40-43,共4页 Chinese Journal of Blood Transfusion
关键词 冷凝集素 自身免疫性溶血性贫血 正反定型不符 交叉配血 抗体筛选 cold agglutination AIHA discrepancy in blood group typing cross matching antibody screening
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