抗-Jk^a致溶血性输血反应结果分析  

Analysis of anti-Jk^a induced hemolytic transfusion reaction

作　　者：张晨光[1] 吴子钊[1] 胡志军[1] 庞桂芝 王亚荣[1] 孔玉凤[3] 贺志安[1] 

机构地区：[1]新乡医学院检验系,河南省新乡市453003 [2]新乡市中心血站,河南省新乡市453003 [3]新乡医学院第三附属医院,河南省新乡市453003

出　　处：《中国组织工程研究与临床康复》2007年第3期570-571,共2页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：新乡市科技项目(06S055)~~

摘　　要：患者,男,69岁,B型血,Rh(D)阳性。1999年因肺癌手术曾输过血,无不良反应。2005-12因化疗致纯红细胞再生障碍性贫血住新乡医学院第三附属医院,入院重度贫血貌,临床申请输血。5d后又输同型压积红细胞悬液2u,当晚出现抽搐、发热、胸闷、畏寒、出汗等症状,经查间接胆红素增高,尿蛋白1+,潜血2+,临床按溶血性输血反应进行处理,患者症状缓解。为查明原因,重新抽取新鲜标本和溶血反应前的标本一同送至新乡市中心血站。通过血型血清学检测来寻找输血反应原因。结果显示,直接抗球蛋白实验为阴性。溶血反应前的标本均未出现凝集和溶血现象,而抗人球蛋白实验检测到患者血清中有不规则抗体存在;溶血反应后的标本均检测到不规则抗体。患者血清中存在抗-Jka,效价为8。A male married patient of 69 years old, who is Han people Of B Rh （D）＊ and transfused in 1999 because of lung cancer operation without side effects was selected. The patient hospitalized in the Third Affiliated Hospital of-Xinxiang Medical College on December 2005 due to aplastic anemia caused by chemical therapy, whose blood sample was sent to the Laboratory for serologic testing. Five days later, 2 u of erythrocyte suspension was transfused, which resulted in convulsion, fever, chest distress, chilly, and diaphoresis. Detection showed that the indirect bilirubin increased with urine protein 1＋ and occult blood 2＋. According to the clinical HTR, the patient was treated and symptoms were relieved. To find out the reasons, fresh samples were recollected and sent to Xinxiang Central Blood Station together with the samples before HTR for rechecking. The causes of transfusion reaction was detected by antiglobulin test of Coombs. The result showed that： It was negative in direct antigiobulin test; there was no agglutination and hemolytic crisis in pre-transfusion sample, while irregular antibodies were found in the Coombs＇ test. After hemolytic reaction, irregular antibody was detected in the sample, and there was anti-Jk^a in the blood sample of the patient; And the anti-Jka titer was 8.

关 键 词：血型抗原 输血 溶 

分 类 号：R457.13[医药卫生—治疗学]