异基因造血干细胞移植患者血型及血型物质转变的临床分析  

Clinical Analysis of Conversions of Blood Group and Blood Group Substances in Patients with Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：梅礼军[1] 王林川[2] 

机构地区：[1]安康市中心医院输血科,陕西安康725000 [2]西安交通大学医学院第一附属医院检验科,陕西西安710061

出　　处：《昆明医科大学学报》2013年第7期75-78,82,共5页Journal of Kunming Medical University

基　　金：陕西省科技攻关基金资助项目(06k11-G4)

摘　　要：目的探讨ABO血型不合异基因造血干细胞移植患者血型及血型物质转变的临床特点,指导临床输血.方法对17例ABO血型不合异基因造血干细胞移植患者进行随访观察,记录移植后红细胞、血小板输注量,移植后植活时间、RBC生长周期及完全转型时间;抗原抗体转换期及转换后血型抗原和抗体效价,比较ABO主侧不合、次侧不合、主次侧均不合患者各检测指标的差异并观察唾液血型物质的转换情况.结果移植后患者血型均转换为供者血型,ABO主侧不合者移植后原抗体减弱后逐渐消失;ABO次侧不合者和ABO主次侧均不合者移植后抗体效价减弱,维持较低水平不变;唾液血型物质长期不变.结论对AB0血型不合患者移植后输血,应根据ABO血型抗体效价选择合适血型的血液制品,对临床疑难血型鉴定,应考虑是否为造血干细胞移植患者而选用不同的辅助血型诊断方法.Objective To investigate the clinical features of the conversions of blood group and blood group substances in patients with ABO-incompatible allogeneic hematopoietic stem cell transplantation.Methods 17 cases with ABO-incompatible allogeneic hematopoietic stem cell transplant were followed up so as to observe the infusions of and RBC and PLT,the engraftment time,the complete transformation time and growth cycle of RBC and blood group antigens and antibody titers.Differences of detection index were compared respectively in the main side,substandard secondary side,primary and secondary side of the ABO incompatibility.Results After the transplantation,the blood groups of all patients were converted into the blood types of the donors,with the original antibody weakened and disappeared gradually in patients of ABO incompatibility on the main side.Antibody titers of ABO decreased in patients of incompatibility on primary and secondary sides and then maintained a lower level.Blood group substances in saliva kept unchanged over the for long period.Conclusions The appropriate blood products and blood type should be selected in accordance with ABO blood group antibody titer in blood replacement for patients with AB0 blood group incompatibility after the transplantation.And for certain blood type difficult to be identified clinically,we should consider whether he/she is a patient of hematopoietic stem cell transplant and use different auxiliary methods in diagnosing the blood group.

关 键 词：ABO血型不合 异基因造血干细胞移植 血型转变 血型物质 

分 类 号：R733.71[医药卫生—肿瘤] R73058[医药卫生—临床医学]