自身抗体干扰输血相容性检测处理对策  

Approaches against the interference of autoantibodies with pre-transfusion compatibility testing

作　　者：刘凤霞[1] 黄蓉[1] 王勇军 周明[3] 桂嵘[1] 谢毓滨[4] 兰炯采[5] 沈伟[6] LIU Fengxia;HUANG Rong;WANG Yongjun;ZHOU Ming;GUI Rong;XIE Yubin;LAN Jiongcai;SHEN Wei(The Third Xiangya Hospital of Central South University,Changsha 410013,China;The Second Xiangya Hospital of Central South University;Hunan Provincial People′s Hospital;Changsha Blood Center;Nanfang Hospital,Southern Medical University;Shanghai Blood Center)

机构地区：[1]中南大学湘雅三医院输血科,湖南长沙410013 [2]中南大学湘雅二医院 [3]湖南省人民医院 [4]长沙血液中心 [5]南方医科大学南方医院 [6]上海市血液中心

出　　处：《中国输血杂志》2021年第8期803-808,共6页Chinese Journal of Blood Transfusion

基　　金：湖南省自然科学基金(2020JJ4840)。

摘　　要：自身免疫性溶血性贫血(AIHA)患者由于存在自身抗体使输血前相容性检测复杂化,若不能正确鉴定这些患者的血型,明确是否存在具有临床意义的同种抗体/自身抗体并及时发出合适的成分血,可能导致输血延误甚至危及生命。正确掌握AIHA患者输血相容性检测处理对策,对于保障AIHA患者的输血及时性和输血安全性意义重大。本文根据国内外研究进展,从AIHA的血清学特点、自身抗体类型、血型鉴定方法、抗体筛查与抗体鉴定方法,以及此类患者的输血策略等方面做出总结,旨在为输血科工作人员排除AIHA患者自身抗体的干扰和输血提供指导。Pre-transfusion compatibility testing is complicated in autoimmune hemolytic anemia(AIHA)patients due to the presence of autoantibodies.Delays in blood transfusion or even life-threatening would occur if blood type,isoantibodies/autoantibodies of these patients could not be correctly identified to choose the appropriate blood components.Knowing the detection and treatment countermeasures against blood transfusion compatibility in AIHA patients is of great significance to ensure the timeliness and safety of blood transfusion.Based on the research progress at home and abroad,this article summarizes the serological characteristics,autoantibody types,blood group identification methods,antibody screening and antibody identification methods,and blood transfusion strategies about AIHA patients,in order to eliminate the interference of autoantibodies and provide transfusion guidance for the staff of Blood Transfusion Department.

关 键 词：自身抗体 自身免疫性溶血性贫血 血型鉴定 抗体筛查 抗体鉴定 交叉配血 

分 类 号：R457.11[医药卫生—治疗学] R446.6[医药卫生—临床医学]