混合抗体型自身免疫性溶血性贫血的血型定型和抗体分析  

Hybrid antibody autoimmune hemolytic anemia blood grouping and antibody analysis of heat and chloroquine elu-tion

作　　者：王洪建[1] 刘小慧[1] 

机构地区：[1]河南省濮阳市人民医院血液病研究所,457000

出　　处：《中国实用医刊》2015年第20期61-63,共3页Chinese Journal of Practical Medicine

摘　　要：目的：探讨混合抗体型自身免疫性溶血性贫血（ AIHA）的血型定型和抗体情况,以期提高临床诊治水平。方法回顾性分析濮阳市人民医院2009年1月至2013年4月收治的23例AIHA患者,均对患者进行分离血清和红细胞,将红细胞进行轻度热放散和氯喹放散试验,采用血型抗原分型的自身吸收实验,取适当血清,加入等量O型红细胞进行抗体吸收、吸收后的血清用于ABO反定型试验,采用PEG法和自身吸收法对自身抗体进行吸收,比较两者在吸收时间、吸收次数和吸收后抗体情况,采用乙醚放散法进行抗体分析。结果所有患者的ABO血型得到正确确定,15例Rh血型得到确定,2种吸收方法处理后血清抗体结果相近,检测自身抗体中有6例合并同种抗体,其中4例得到确定,2例为不确定,其他的均为单纯自身抗体, PEG吸收法在吸收时间上明显较自身吸收法短。结论轻度热放散和氯喹放散法结合适合于临床上混合抗体型AIHA患者血型定型前红细胞处理。 PEG吸收法快速、简单、吸收效果良好。Objective To analyze the blood grouping and antibody circumstances in patients with autoimmune he-molytic anemia（ AIHA） , and thus to improve the clinical diagnosis and therapy. Methods From January 2009 to April 2013, 23 patients with AIHA were analyzed retrospectively. Patient’s RBC was used for ABO and rhesus typing test after it had eluted with gently heat and chloroquine. The ABO reverse typing test was performed after the autoantibodies in patient’ s plasma had been absorbed with O group blood cell. Polyethylene glycol adsorption method and auto-adsorption method were studied by comparing the total time and numbers of the adsorption. Antibodies were identified with ethylether elute. Results ABO and Rh blood group were typed correctly in 23 cases and 15 cases respectively. Two kinds of serum antibody absorption method after treatment was similar. Six cases were detected to have both allo-antibody and auo-antibody, howev-er, antibodies specificity had not been identified in 2 cases, others were simply autoantibodies, PEG absorption was signifi-cantly shorter than auto-adsorption on the time. Conclusions Gently heat elute combines chloroquine elute is a good choice to perform blood group typing test for AIHA patients with both cold and warm autoantibodies. PEG absorption meth-od is rapid, simple and effective to remove autoantibody and detect underlying alloantibody.

关 键 词：混合抗体型 自身免疫性溶血性贫血 放散 吸收 氯喹 

分 类 号：R556.62[医药卫生—血液循环系统疾病]