摘要
目的分析1例免疫性溶血性输血反应的发生原因,鉴定相关抗体,探讨输血相容性检测中的有关试验方法。方法ABO/Rh血型鉴定、血清及放散液不规则抗体鉴定、直接抗人球蛋白试验、交叉配血试验采用盐水法和/或微柱凝胶法检测。结果患者血型为O、DCCee,直抗试验阴性,检出较强的抗-E和弱的抗-c,末次输血后发生急性溶血性输血反应。结论目前我国免疫性溶血性输血反应仍以Rh血型系统抗体引起的为主。本例患者输血前未做不规则抗体筛查,且患者血清所含抗-c抗体反应弱,导致交叉配血漏检不配合性从而发生急性溶血性输血反应。建议输血前常规开展不规则抗体筛查工作,当怀疑发生急性溶血性输血反应时宜尽早采样检测,以提高直抗试验的准确性。
Objective To analyze the causes of immune hemolytic transfusion reaction in one case,identify related antibodies,and explore transfusion compatibility testing.Methods ABO/Rh blood group identification,unexpected antibody identification of serum and diffusion fluid,direct antiglobulin test(DAT)and cross matching were conducted by saline method and/or microcolumn gel method.Results The patient's blood group was O,and Rh phenotype was identified as DCCee.The DAT was negative,with strong anti-E antibody and weak anti-c antibody detected.Acute hemolytic transfusion reaction occurred in the patient after the last transfusion.Conclusion Currently,immune hemolytic transfusion reaction in China are mainly caused by Rh blood group system antibodies.The absence of unexpected antibody screening before blood transfusion and the weak anti-c antibody which resulted in missed detection of non compatibility in cross matching led to acute hemolytic transfusion reaction.It is recommended to conduct unexpected antibody screening before blood transfusion,and to collect blood sample for testing as soon as possible to improve the accuracy of DAT when acute hemolytic transfusion reaction is sus-pected.
作者
焦秀娟
刘专
黄宏亮
JIAO Xiujuan;LIU Zhuan;HUANG Hongliang(Yancheng Blood Center,Yancheng 224005,China)
出处
《中国输血杂志》
CAS
2023年第11期1064-1067,共4页
Chinese Journal of Blood Transfusion
关键词
溶血性输血反应
RH血型
不规则抗体
抗-E
抗-C
hemolytic transfusion reaction
Rh blood group
unexpected antibody
anti-E
anti-c
