恶性肿瘤和血液病患者ABO血型抗原弱表达及输血对策  

Reduction of ABO blood group antigen in patients with malignancy cancers and hematological diseases and its measures of blood transfusion

作　　者：吴争胜[1] 彭燕[2] 

机构地区：[1]浙江省人民医院输血科,浙江杭州310014 [2]温州医学院

出　　处：《全科医学临床与教育》2010年第3期262-264,共3页Clinical Education of General Practice

摘　　要：目的对恶性肿瘤及血液病患者ABO血型抗原弱表达进行系统性分析并对其输血对策进行探讨。方法随机抽取恶性实体肿瘤及血液病患者198例,查阅诊断和输血情况,并对抗原弱表达的病例进行吸收放散、唾液中和等试验鉴定正确血型,同时将两种病情结果进行对照分析。结果发现两种病情均有呈现ABO血型抗原弱表达情况,分别为1.65%、20.78%,血液病患者抗原弱表达明显高于恶性实体肿瘤病例(χ2=18.58,P<0.05)。因贫血而导致的血液病输血病例中,输注同型血与输注洗涤红细胞后血红蛋白值相比差异无统计学意义(t=1.76,P>0.05)。结论采用血清学正反定型试验、吸收放散试验和唾液血型物质检测的方法可以更为准确对ABO血型抗原弱表达的病例进行血型鉴定,输血时以输注正确鉴定的同型血为原则,特殊情况下输O型洗涤红细胞更为安全。Objective To make a systemic study between the reduction of ABO blood group antigen in patients with malignancy cancers and hematological diseases, and to research the countermeasures of blood transfusion. Methods Totally 198 samples were collected from patients who suffered from malignancy cancers and hematological diseases by random. Medical records about diagnosis and transfusion details were consulted. In the meantime, absorption-elution testing and saliva blood group substance analysis were performed to identify the blood group of the samples with the reduction of antigen, and the results between the two kinds of illness were analyzed by contrast. Results The two kinds of illness all presented the reduction of ABO blood group antigen at 1.65% and 20.78%. The reduction of ABO blood group antigen in the hematological diseases was obviously higher than that in the malignancy cancers （χ^2=18.58, P〈0.05）. There was no significant difference between the homotype blood transfusion and O washed red b1ood cells transfusion （t=1.76, P〉0.05）. Conclusions It is more accurate to identify the samples of the reduction of ABO blood group antigen by means of the forward and reverse typing,absorption-elution testing and saliva blood group substance analysis. Homotype blood transfusion is recommended,and it is safer to use O washed red blood cells in emergency.

关 键 词：恶性肿瘤 血液病 ABO血型 抗原弱表达 输血 

分 类 号：R730.5[医药卫生—肿瘤] R55[医药卫生—临床医学]