献血者O型血清抗-A、抗-B完全抗体与不完全抗体效价的调查分析  

Investigation and analysis of anti-A/B complete and incomplete antibody titers in blood group O serum

作　　者：肖瑞卿[1] 赵树铭[1] 林武存[1] 隆晓秋[1] 刘景汉[2] 

机构地区：[1]第三军医大学附属西南医院输血科,重庆400038 [2]中国人民解放军总医院输血科,北京100039

出　　处：《第三军医大学学报》2003年第10期916-917,共2页Journal of Third Military Medical University

基　　金：全军"十五"指令性课题 ( 0 1L0 4 5 0 1)

摘　　要：目的　调查O型血清中抗 A、抗 B抗体效价浓度 ,分析其在临床输血中的意义。方法　用部分中和后抗球蛋白法及盐水法检测 10 0例O型献血者的完全与不完全血型抗体效价。结果　 10 0例O型供血者中 ,IgM抗 A抗体效价在 1∶64以上占 3 7例 ,IgM抗 B抗体效价在 1∶64以上 42例。因此 ,当输注O型全血或血浆时 ,约 40 %或每 5单位 ( 10 0 0ml)就有 2单位的抗 A、抗 B抗体效价超过 1∶64。尽管A型、B型人的血中分别含有A或B抗原可以中和部分IgM抗体。含有IgG的抗 AB抗体也不能被中和。结论　上述结果提示 ,O型血浆最好是输给同型血受体 ,不要输给异型血受体 ;另外 ,O型的母亲怀孕其他血型胎儿时 ,母亲体内的不完全抗体可以通过胎盘引起新生儿溶血病 ,提示有必要对孕妇做产前检查。Objective To study the anti A and/or anti B antibody titers in blood group O serum, and to discuss its significance on clinical transfusion. Methods The anti A and anti B complete and incomplete blood group antibodies in blood group O donors of 100 cases were detected. Results The IgM anti A antibody titer over 1∶64 was found in 37 cases, but IgM anti B antibody titer over 1∶64 was found in 42 cases. Thus the Anti A/B antibody titer of approximate 40% samples or 2 units out of 5 (1 000 ml) surpassed 1∶64 when infusion of type O whole blood or plasma was performed. The A or B antigen contained in type A or type B blood could neutralize partial IgM antibodies, but anti AB antibodies containing IgG could not be neutralized. Conclusion Type O plasma should be transfused preferably to patients with the same blood group, rather than to those with incompatible one. Additionally, when blood group of fetus is different from mother's type O blood group, erythroblastosis fetalis may be induced by the maternal transplacental incomeplete antibody due to blood group incompatibility. This indicates that prenatal examination is indispensable.

关 键 词：ABO血型系统 输血 血型不相容 新生儿溶血病 

分 类 号：R181.24[医药卫生—流行病学] R457.13[医药卫生—公共卫生与预防医学]