静脉注射人免疫球蛋白对输血相容性试验的影响  

Influence of intravenous injection of human immunoglobulin on blood transfusion compatibility test

作　　者：黄文娟 刘不尽[2] 蒋玉林 毛伟[2] 唐彦[1] HUANG Wenjuan;LIU Bujin;JIANG Yulin;MAO Wei;TANG Yan(Department of Clinical Laboratory,Chongqing Orthopedic Hospital of Traditional Chinese Medicine,Chongqing 400010,China;Institute of Blood Transfusion,Chongqing Blood Center,Chongqing 400050,China)

机构地区：[1]重庆市中医骨科医院医学检验科,重庆400010 [2]重庆市血液中心输血研究所,重庆400050

出　　处：《检验医学与临床》2022年第13期1778-1780,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨静脉注射人免疫球蛋白(IVIG)对输血相容性试验的影响。方法将经过检测为正常ABO血型的献血者红细胞按照A、B、O、AB血型分为A、B、O、AB 4组,制成5%悬液。IVIG倍比稀释后,对以上4组红细胞进行致敏,采用直接抗人球蛋白试验检测红细胞的致敏效果;对致敏后的红细胞进行热放散试验,并检测热放散试验后上清液中存在的抗体。结果4组红细胞均可被稀释比例为1∶4的IVIG致敏,其中A组和AB组红细胞致敏强度最强,O组最弱;IVIG稀释比例为1∶8时,可观察到稀释后的抗体对A组红细胞致敏强度仍最强,AB组红细胞被致敏强度次之,B组红细胞极少被致敏,O组红细胞为阴性。致敏后4组细胞中A组能放散出与A型和AB型红细胞反应的抗体;B组能放散出与B型和AB型红细胞反应的抗体;AB组能放散出与A、B、O、AB型红细胞反应的抗体。结论IVIG可体外致敏红细胞,致敏效果较好的是A型和AB型红细胞,O型红细胞致敏效果最差。致敏后的红细胞能放散出影响ABO血型鉴定和交叉配血的抗体,IVIG可能影响输血相容性试验结果。Objective To study the effect of intravenous injection human immunoglobulin(IVIG)on transfusion compatibility test.Methods The red blood cells of blood donors with normal ABO blood group were divided into A,B,O and AB 4 groups according to blood groups A,B,O and AB,and made into 5%suspension.After IVIG doubling dilution,the above 4 groups of red blood cells were sensitized,and the sensitization effect of red blood cells was detected by direct anti-human globulin test.A heat release test was performed on the sensitized red blood cells,and the presence of antibodies in the supernatant after the heat relesae test was detected.Results The red blood cells in the 4 groups could be sensitized by IVIG with a dilution ratio of 1∶4,among which the sensitization intensity of red blood cells in A and AB group was the strongest,and O group was the weakest.When the IVIG dilution ratio was 1∶8,it observed that the sensitization intensity of the diluted antibody to the red blood cells in A group were still the strongest,the red blood cells in AB group were less sensitized,the red blood cells in B group were rarely sensitized,and the red blood cells in O group were negative.After sensitization,among the 4 groups,A group could release antibodies that reacted with type A and AB red blood cells;B group could release antibodies that reacted with type B and AB red blood cells;AB group could release antibodies that reacted with type A,B,O,AB red blood cells.Conclusion IVIG could sensitize red blood cells in vitro,and the sensitization effect is better for type A and AB red blood cells,and the sensitization effect of type O red blood cells is the worst.Sensitized red blood cells could release antibodies that affect ABO blood typing and cross-matching,and IVIG might affect the results of transfusion compatibility tests.

关 键 词：静脉注射人免疫球蛋白 溶血反应 交叉配血 

分 类 号：R457.1[医药卫生—治疗学]