儿童抗-M引起的血型鉴定困难分析7例  

Analysis of ABO blood group discrepancy caused by anti-M antibidy in pediatric patients

作　　者：顾萍 傅启华[1] 王静[1] 

机构地区：[1]上海交通大学医学院附属上海儿童医学中心输血科,上海200127

出　　处：《中国输血杂志》2015年第8期1009-1011,共3页Chinese Journal of Blood Transfusion

基　　金：上海市卫生局公共卫生优秀学科带头人培养计划(GWDTR201226)

摘　　要：目的通过对血型系统中抗-M的鉴定,分析引起儿童血型鉴定正反定型不符的原因。方法 7例患儿均来自上海儿童医学中心,血型鉴定发现正反结果不符。其中男6例,女1例,年龄为1 d-11岁。采用Diagnostic Grifols,S.A公司的DG Gel Confirm卡、Neutral卡、Coombs卡以及WADiana/8XT Compact Analyzer全自动系统进行血型鉴定、抗体筛查。结果 7例标本的血型鉴定反定型中,均表现为O细胞凝集现象,说明有ABO系统以外的抗体存在。7例标本进行抗体筛查均为阳性。抗体鉴定后,根据谱细胞的反应格局,判断为抗-M。对抗-M进行Ig G和Ig M的分型后,发现1例标本不存在Ig M型,另1标本不存在Ig G型,其余均为Ig G和Ig M型同时存在,其效价在1∶4—1∶32之间。Ig G和Ig M型的抗-M均可引起抗体筛查阳性和血型鉴定困难。结论儿童进行ABO血型鉴定时应同时做正反定型,发现正反定型不符时有必要进行抗体鉴定,以发现具有临床意义的不规则抗体,寻找相应抗原阴性的血液与患者进行交叉配血试验,保障儿童输血安全。Objective To analyze the pediatric blood typing discrepancy by identifying the anti-M antibody. Methods Seven pediatric patients enrolled in this study were from Shanghai Children＇s Medical Center, all showed discrepancy in ABO blood group identification. Six patients were male and one was female, aged from 1 day to 11 year-old. Blood group identification and antibody screening were performed with DG Gel Confirm cards, Neutral cards, Coombs cards and WADiana/8XT Compact Analyzer （Diagnostic Grifols, S.A. ）. Results AU 7 samples agglutinated with O cell in the reverse tests that indicated the existence of antibodies other than ABO blood group system. The results of antibody screening tests were all positive. The anti-M antibody was identified based on the response pattern of panel cells. The IgG and IgM anti-M existed simultaneously in five samples, while the rest two had IgG or IgM isoforms, respectively. The titers of the antibodies were between 1 ： 4 and 1： 32. Both IgG and IgM anti-M antibodies would cause the positive results of antibody screening and blood typing discrepancy. Conclusion To ensure the safety of pediatric transfusion, the forward and reverse tests should be done at the same time when identifying the ABO blood group. Onee the blood grouping discrepancy was identified, antibody identification should be done to discover the irregular antibodies of clinical significance and to find antigen negative compatible blood to crossmatch with patient.

关 键 词：ABO血型 MNSS血型 抗-M 抗体效价 

分 类 号：R457.11[医药卫生—治疗学]