摘要
目的探讨ZZAP试剂处理同种异体红细胞用于吸收试验,在排除红细胞自身抗体对输血前试验干扰中的应用价值。方法对2017年1月至2024年2月该中心收治的413例因红细胞自身抗体干扰输血前试验的病例标本进行血清学特征的回顾性分析,采用不同方法进行抗体鉴定,根据抗体鉴定时方法使用情况将患者分为3组,即自身吸收组(以自身细胞吸收试验后的血清行抗体鉴定及交叉配血,n=87)、未吸收组(患者血清行抗体鉴定及交叉配血,n=277)、同种吸收组(以ZZAP试剂处理后的异体同种红细胞吸收试验后的血清行抗体鉴定及交叉配血,n=49),并选取其中77例经ZZAP试剂处理的异体细胞吸收和未经吸收试验的患者,详细调查输血有效率及同种抗体检出情况,比较输血前后血红蛋白、红细胞计数、红细胞比容变化,分析ZZAP试剂处理异体细胞后的同种细胞吸收方法对排除自身抗体干扰及提高输血疗效的作用。结果存在红细胞自身抗体患者的抗人球蛋白试验(直接法)分型结果多为IgG阳性和IgG+C3d阳性,自身抗体多为温自身抗体和冷温混合型自身抗体。同种吸收组和未吸收组的患者输血后血红蛋白、红细胞计数、红细胞比容较输血前均有改善。同种吸收组的同种抗体检出率(42.86%)显著高于未吸收组的检出率(12.64%)及自身吸收组的检出率(11.49%),差异有统计学意义(P<0.001)。同种吸收组输血总有效率(95.92%)显著高于未吸收组(78.57%),差异有统计学意义(P=0.016)。结论经ZZAP试剂处理的同种细胞吸收,可作为自身吸收不可操作时的替代方案,有效地排除自身抗体对输血前试验的干扰,提高输血安全性和有效性。
Objective To explore the application value of ZZAP reagent in treating allogeneic erythrocytes for absorption experiment use and in excluding the interference of erythrocyte autoantibodies in pre-transfusion tests.Methods The serological characteristics of 413 cases of erythrocyte autoantibodies interference in pre-transfusion tests in this center from January 2017 to February 2024 was retrospectively analyzed.The antibody identification adopted different methods.The patients were divided into 3 groups according to the antibody identification method:self-absorption group(the serum after autologous cell absorption test conducted the antibody identification and cross matching,n=87),unabsorption group(the serum of the patients conducted the antibody identification and cross-matched,n=277)and allogenic absorption group(the serum after allogeneic erythrocyte absorption test treated by ZZAP reagent condcuted the antibody identification and cross-matched,n=49).Among them,77 cases of allogenic absorption treated by ZZAP reagent and without absorption test were selected and conduct the detailed survey on the blood infusion effective rate and iso-antibody detection situation.The changes of red blood cell(RBC)count,hemoglobin(Hb)and hematocrit(Hct)were compared before and after blood transfusion.The effect of allogenic cells absorption method for excluding the autoantibodies interference and increasing the blood transfusion effect after ZZAP reagent treating allogenic cells was analyzed.Results The typing results of antihuman globulin test(direct method)in the patients with RBC atoantibodies were mainly IgG positive and IgG+C3d positive,and the autoantibodies were mainly the warm autoantibodies and cold and warm mixed autoantibodies.HB,RBC Hct after blood transfusion in the allogenic absorption group and unabsorption group all were improved.The alloantibody detection rate in the allogenic adsorption group was 42.86%,which was significantly higher than 12.64%in the unabsorbed group and 11.49%in the autologous adsorption grou
作者
刘不尽
崔丹荔
邹海曼
卿芸
代华友
黄霞
LIU Bujin;CUI Danli;ZOU Haiman;QING Yun;DAI Huayou;HUANG Xia(Second Institute of Blood Transfusion Research,Chongqing Municipal Blood Center,Chongqing 400052,China)
出处
《重庆医学》
CAS
2024年第20期3072-3076,共5页
Chongqing Medical Journal
基金
重庆市科卫联合医学科研项目(2022MSXM128)
重庆市自然科学基金项目(CSTB2022NSCQ-MSX1237)。
