自身免疫性溶血性贫血的抗体鉴定及输血治疗一例  

Antibody identification and blood transfusion for autoimmune hemolytic anemia: a case report

作　　者：刘相富[1] 廖志坚[2] 邝丽华[1] 陆英[1] 邹勇[1] 袁青[1] 廖思红[1] 刘贵连[1] 

机构地区：[1]中山大学附属第三医院输血科,广州510630 [2]广州血液中心临床输血研究所,广州510630

出　　处：《新医学》2016年第11期778-781,共4页Journal of New Medicine

摘　　要：自身免疫性溶血性贫血(AIHA)患者的自身抗体存在复杂性,该类患者常难以找到与其完全相合的血液而无接受输血治疗,最终因极度贫血引起相关并发症而死亡。该文报道1例5个月的特异性自身抗体AIHA患儿,其因全身及双目黄染而入院,检测直接抗人球蛋白(Coombs)和间接抗人球蛋白试验均阳性,诊断为急性溶血性贫血、AIHA、重度贫血,通过抗体筛查与鉴定,考虑其存在类抗-Ce的特异性自身抗体,选择与患儿Rh格局相同且交叉配血反应最弱的血液进行输注,输血过程顺利,无不良反应。经2次输血后患儿血红蛋白浓度由入院时的32 g/L先后增加至51 g/L和84 g/L。因此,对于该类患者,如果有条件应尽量选用与其Rh系统分型一致的血液输注,以尽量减少其产生Rh同种抗体的可能性,降低再次输血配血的难度。Due to the complexity of autoantibody,autoimmune hemolytic anemia （AIHA）patients cannot receive blood transfusion therapy because of the difficulty in blood matching.AIHA patients may die from relevant complications induced by severe anemia.In this paper,we reported a 5-month-old child diagnosed with AIHA.The child was admitted to our hospital due to systemic and scleral icterus.Both direct （Coombs）and indirect anti-globulin tests yielded positive results.The child was diagnosed with AIHA and severe anemia.Antibody screening and identification identified specific anti-Ce autoantibody.Blood transfusion with identical Rh type and the least cross-matching response was successfully performed without adverse events.Upon admission,the hemoglobin concentration was 32 g/L,significantly elevated to 51 g/L and 84 g/L after twice blood transfusions.Therefore,blood transfusion with identical Rh type is highly recommended for AIHA patients to reduce the possibility of production of identical Rh-type antibody and decrease the difficulty of repeated blood transfusion and matching.

关 键 词：自身抗体 自身免疫性溶血性贫血 输血 抗体鉴定 

分 类 号：R457.1[医药卫生—治疗学] R556.61[医药卫生—临床医学]