北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2014年
8期
685-688
,共4页
庄光艳%张烨%刘素芳%张磊
莊光豔%張燁%劉素芳%張磊
장광염%장엽%류소방%장뢰
ABO血型%同种抗体%自身抗体%临床输血
ABO血型%同種抗體%自身抗體%臨床輸血
ABO혈형%동충항체%자신항체%림상수혈
ABO blood type%Allo-antibody%Auto-antibody%Clinical transfusion
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。
目的：分析血液病對輸血前檢查中抗體檢測的影響，選擇閤理的ABO血型鑒定、抗體篩選和交扠配血方法。方法對2012年7月至2014年2月422例臨床確診為血液病併送本室進行疑難定型和交扠配血的患者血液標本，進行ABO血型鑒定、抗體篩選和鑒定及交扠配血，採用血型血清學方法及PCR-SSP血型基因檢測鑒定ABO血型。採用鹽水法、LISS-IAT法（微柱凝集）、經典-IAT法進行抗體篩選和鑒定及交扠配血。結果422例患者中，127例（30.09%）試管法正反定型相符，可確定ABO血型；74例（17.54%）抗原減弱；221例（52.37%）反定型抗體減弱或異常，其中自身免疫性溶血性貧血（AIHA）75例（33.94%），多髮性骨髓瘤（MM）72例（32.58%），其餘為骨髓增生異常綜閤徵（MDS）、再生障礙性貧血（AA）、急性淋巴細胞白血病（ALL）、淋巴瘤患者。這221例患者中，存在同種抗體37例，自身抗體65例，同種+自身抗體9例。結論血液病影響輸血前檢查中的抗體檢測。 ABO抗體減弱或異常最常見于AIHA和MM；血液病患者常因輸血產生同種抗體，且很多患者體內存在自身抗體，應根據抗體檢測的結果選擇閤適的交扠配血方法，保障輸血安全。
목적：분석혈액병대수혈전검사중항체검측적영향，선택합리적ABO혈형감정、항체사선화교차배혈방법。방법대2012년7월지2014년2월422례림상학진위혈액병병송본실진행의난정형화교차배혈적환자혈액표본，진행ABO혈형감정、항체사선화감정급교차배혈，채용혈형혈청학방법급PCR-SSP혈형기인검측감정ABO혈형。채용염수법、LISS-IAT법（미주응집）、경전-IAT법진행항체사선화감정급교차배혈。결과422례환자중，127례（30.09%）시관법정반정형상부，가학정ABO혈형；74례（17.54%）항원감약；221례（52.37%）반정형항체감약혹이상，기중자신면역성용혈성빈혈（AIHA）75례（33.94%），다발성골수류（MM）72례（32.58%），기여위골수증생이상종합정（MDS）、재생장애성빈혈（AA）、급성림파세포백혈병（ALL）、림파류환자。저221례환자중，존재동충항체37례，자신항체65례，동충+자신항체9례。결론혈액병영향수혈전검사중적항체검측。 ABO항체감약혹이상최상견우AIHA화MM；혈액병환자상인수혈산생동충항체，차흔다환자체내존재자신항체，응근거항체검측적결과선택합괄적교차배혈방법，보장수혈안전。
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.
