凝胶卡血型鉴定正反不一致的原因分析  

Analysis for Discordance of Positive and Negative Blood Typing by Gel Card

作　　者：李翠莹[1] 徐弘[2] 雷慧芬[1] 刘娟[1] 李小薇[1] 

机构地区：[1]空军总医院输血科,北京100142 [2]成都军区总医院输血科,四川成都610083

出　　处：《中国实验血液学杂志》2017年第4期1199-1202,共4页Journal of Experimental Hematology

摘　　要：目的:探讨凝胶卡法鉴定ABO血型正反定型不一致的原因及其疾病分布的影响因素,并提出解决方法。方法:收集凝胶卡初检血型正反定型不一致血液标本240例,送血型参比实验室做经典试管法及唾液血型物质等血清学实验,在血清学方法无法确定时进行基因分型方法试验。结果:在ABO血型正反定型初检不一致标本240例中,假凝集采用试管法后正反定型一致107例(44.58%),不一致的133例(55.42%),其中冷凝集素35例(14.58%)、AB抗原性减弱22例(9.17%)、ABO亚型16例(6.67%)、直抗阳性12例(5.00%)、抗体缺失或减弱11例(4.58%)、因药物及蛋白引起假凝集11例(4.58%)、唾液血型物质11例(4.58%)、ABO血型以外的同种抗体8例(3.33%)、异基因骨髓移植7例(2.92%);疾病分布情况为:血液病(16.83%)、肿瘤(11.88%)、心肺疾病(11.39%),经卡方适度检验分析,疾病分布差异显著。结论:ABO血型正反定型不一致有多种因素影响,其中凝胶卡血型鉴定假阳性较多;在血液病、肿瘤、心肺疾病等方面高发,应予以足够的重视。Objective： To explore the method of Gel card identifying ABO blood group,determine the inconsistent cause and the distribution of disease affecting factors,and put forward a method of its solutions. Methods： To collect 240 positive and negative typing-discordant blood speciments from patients examined by Gel card and send these speciments to blood type reference laboratory for examining with the classic tube method and serological test,such as salivary blood-group substance,in order to performe genotyping method when serologic test can not be determined. Results： Among240 positive and negative typing-discordant blood speciments from patients examined by Gel card,107 blood speciments were positive and negative consistent examined by false agglutination test（ 44. 58%）,133 blood specinents were discordent examined by false agglutination（ 55. 42%）,out of them,35 cases（ 14. 58%） with inconsistent cold agglutination test,22 cases（ 9. 17%） with weakened AB antigenicity,16 cases（ 6. 67%） with ABO subtyping,12cases（ 5. 00%） with positive direct antiglobulin test,11 cases（ 4. 58%） with reduced or without antibodies,11 cases（ 4. 58%） with false aggregation caused by drugs or protein,11 cases（ 4. 58%） with salivary blood-type substances,8cases（ 3. 33%） with non-ABO alloantibody,and 7 cases（ 2. 92%） with allogeneic bone marrow transplantation. The distribution of disease were following： blood disease（ 16. 83%）,tumor（ 11. 88%）,and cardiopulmonary diseases（ 11. 39%）; chi-square test results indicated that the distribution significantly different. Conclusion： The analysis of ABO blood grouping shows a variety factors influencing positive and negative blood typing,and the Gel Card identification can produc more false positive blood types. Therefore,more attention should be paid on the high incidence diseases,such as blood disease,tumor,and cardiopulmonary disease.

关 键 词：ABO血型 凝胶卡 正定型 反定型 

分 类 号：R446.11[医药卫生—诊断学] R157.11[医药卫生—临床医学]