O型洗涤红细胞残留ABO血型抗体检测及非O型患儿输注安全性观察  

Detection of Residual ABO Antibody in Washed Red Blood Cell of Group O and Its Safety of the Application in Pediatric Patients

作　　者：马曙轩[1] 宋文琪[1] 赵宇东[2] 靳剑芸[1] 邵华[1] 

机构地区：[1]首都医科大学附属北京儿童医院输血科,北京100045 [2]首都医科大学附属北京儿童医院心脏外科,北京100045

出　　处：《现代检验医学杂志》2013年第1期114-116,共3页Journal of Modern Laboratory Medicine

摘　　要：目的 采用多种血型血清学方法检测O型洗涤红细胞中残留ABO血型抗体（IgM抗-A,抗-B;IgG抗-A和抗-B）的含量,观察非O型患儿输注O型洗涤红细胞的安全性.方法 取O型洗涤红细胞上清,首先采用盐水试管法检测其中IgM抗-A、抗-B含量.再用凝聚胺法、微柱凝胶法、手工抗人球蛋白法检测其中IgG抗-A、抗-B含量.选取非O型患儿输注O型洗涤红细胞者（异型组）与年龄体重相当的输等量同型洗涤红细胞的患儿（同型组）,分别比较2组患儿输血前后血红蛋白上升幅度、总胆红素和直接胆红素水平、直接coombs试验结果.结果 共检测O型洗涤红细胞上清液597份,盐水试管法在室温及4℃ 条件下均未观察到凝集现象,显微镜下也未观察到凝集现象.凝聚胺法、微柱凝胶法、手工抗人球蛋白法检测IgG抗-A和抗-B均为阴性.2组患儿输血前后血红蛋白上升幅度、总胆红素和直接胆红素水平差异无统计学显著性意义（t值分别为0.19,0.22和0.13,P＞ 0.05）,直接coombs试验均为阴性.结论 血型血清学方法无法检出O型洗涤红细胞中残留ABO血型抗体.非O型患儿输注O型洗涤红细胞是安全的.Objective To detect the residual ABO antibodies （IgM anti-A and anti-B,IgG anti-A and anti-B） in the washed group O red blood cell supernate and to observe the safety of its application in pediatric patients. Methods Immediate spin tube test was carried out to detect IgM anti-A and anti-B in the supernate. Polybrene,microtube gel technology and mannul anti-human globulin assays were used separately to detect IgG anti-A and anti-B in the supernate. After receiving typed O washed red blood cell, the level of hemoglobin,content of total bilirubin and direct bilirubin and the results of direct coombs test were compared in children typed O and typed A,B or AB. Resulls Altogether 597 units of washed red blood cell were detected, IgM anti-A and anti-B were not detected by immediate spin tube test,even after incubation at 4℃ refrigerator and observation under microscope. IgG anti-A and anti-B were not detected by polybrene, microtube gel technology and manual anti-human glublin assay in the supernate. The difference of the level of hemoglobin,content of total bilirubin and direct bilirubin in two groups was not obvious （t= 0.19,0. 22,0.13, P〉 0. 05）. Conclusion Serologic assays were not able to detect the residual IgG and IgM anti-A or anti-B in the supernate of washed group O red blood cell. It would be safe that typed A, B or AB children received group O washed red blood cell.

关 键 词：洗涤红细胞 O型 ABO血型抗体 儿童 

分 类 号：R457.13[医药卫生—治疗学]