特殊自身抗体的鉴定及相关输血分析  

Identification of special autoantibodies and analysis of related blood transfusion applications

作　　者：左琴琴[1] 吴大洲[1] 毛娟[1] 张薇薇 龚福利 徐华[1] ZUO Qinqin, WU Dazhou, MAO Juan, Zhang weiwei, Gong fuli, XU Hua.(Shaanxi Blood Center,Xi＇an 710061 ,Chin)

机构地区：[1]陕西省血液中心

出　　处：《中国输血杂志》2018年第1期64-66,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨特殊自身抗体在临床疑难配血中的鉴定及输血策略。方法血清学检测2名患者ABO、Rh、Kidd、Lewis血型;同时对其进行不规则抗体的筛查与鉴定;对患者2的ABO基因启动子、外显子6、外显子7及FUT1基因序列进行扩增并测序;依最低不相合原则选择合适的血液交叉配血。结果患者1血型为B型C＋c-D＋E-e＋、Jk（a-b＋）、Le（a＋b-）,存在类IgG-C同种特异性自身抗体;患者2为AB型C＋c＋D＋E-e＋、Jk（a＋b-）、Le（a＋b-）,可能存在IgM-H抗体,基因分型为A102/B101,ABO基因启动子、外显子6、外显子7、FUT1基因的外显子4 DNA序列测定,均未发现突变位点。结论存在特殊自身抗体的患者在交叉配血选择血液时,选择ABO、Rh血型同患者的最低不相合血液,可以在提高输血疗效的同时降低输血不良反应的发生,达到及时、安全、有效的输血目标。Objective To investigate the identification and transfusion strategy for specific autoantibodies in clinical blood matching complications. Methods Detection of two patients was performed regarding the ABO,Rh,Kidd,Lewis blood groups with serologic tests; Meanwhile,tests for screening and identification of irregular antibodies were conducted as well; ABO gene promoter,EXON6,EXON7 and FUT1 gene sequences were amplified and sequenced for the second patient;Selecting the appropriate blood to crossmatch according to the least incompatibility principle. Results The blood type of first patient is B,C＋c-D＋E-e＋,JK（a-b＋）,Le（a＋b-）,and IgG-C isotype specific autoantibodies were detected in the serum; The second patient is AB,C＋c＋D＋E-e＋,JK（a＋b-）,Le（a＋b-）. The presence of IgM-H antibody cannot be fully confirmed according to our data and the genotype is A102/B101. DNA sequencing showed no mutation sites in the ABO gene promoter,EXON6,EXON7,and EXON4 of FUT1 gene. Conclusion When blood crossmatching the patients with special autoantibodies,we recommend using the least incompatibility blood to transfuse,which can improve curative effect and reduce the occurrence of adverse transfusion reaction. This helps to achieve our goal of timely,effective and safe transfusion.

关 键 词：自身抗体 疑难配血 最低不相合 

分 类 号：R457.11[医药卫生—治疗学]