268例不规则抗体筛查阳性患者紧急输血体会  

Experience of emergency blood transfusion in 268 patients with positive irregular antibody screening

作　　者：夏帆 付有荣[1] 刘潘[1] XIA Fan;FU Yourong;LIU Pan(Dept.of Blood Transfusion,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院输血科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2022年第6期993-996,共4页Medical Journal of Wuhan University

摘　　要：目的:探讨最适于不同情况导致不规则抗体筛查(抗筛)阳性患者紧急输血方案,保障患者用血安全。方法:选取268例抗筛阳性的待输血患者,根据抗筛3组细胞阳性情况,将样本分为A、B两组,其中A组(53例)样本的抗筛3组细胞均为阳性,B组(215例)为余下的其他样本,A组样本选用经2⁃巯基乙醇(2⁃Me)处理后的红细胞复查抗筛、抗体鉴定及凝聚胺交叉配血实验;B组样本做不规则抗体鉴定及Rh分型,根据鉴定结果再做交叉配血实验。结果:A组中有28例患者使用过CD38单抗类药物,另外25例为自身抗体导致的抗筛阳性,其中21例输注相配合红细胞后24 h复查血红蛋白提示输注有效,4例无法筛选出相配合的血液;B组样本做不规则抗体鉴定、Rh分型检测及交叉配血实验后,199例能筛选出配血相合的红细胞且患者输注后24 h复查血红蛋白提示输注有效,16例无法筛选出相配合红细胞。结论:针对不同类型的抗筛阳性患者,快速找到输血方案,保障患者用血安全。Objective:To discuss the most suitable emergency blood transfusion plan for patients with posi⁃tive irregular antibody screening in different situations,so as to ensure the safety of blood transfusion.Methods:A total of 268 samples from patients with positive irregular antibody screening(anti⁃screen⁃ing)were selected,according to the positive cells of the three groups of anti⁃screening,the samples were divided into two groups.Group A(53 cases)were positive in anti⁃screening of all the three groups of blood cells,while group B(215 cases)were all the remaining samples.The samples of group A were screened with red blood cells treated with 2⁃mercaptoethanol(2⁃Me)for re⁃examination of irregular antibodies,and cross⁃matched by the method of polybrene.In the blood test,the samples of group B were subjected to irregular antibody identification and Rh typing,and performed cross⁃matching experiments based on the identification results.Results:In group A,28 patients had used CD38 monoclonal antibody drugs,another 25 positive cases for irregular antibody screening caused by autoantibodies.After the irregular antibody identification,Rh typing,and cross⁃matching test of the samples in group B,199 cases were screened for matching red blood,and the re⁃examination of hemo⁃globin 24 hours after the infusion indicated that the infusion was effective;only in 16 cases of group B,suitable red blood cells could not be screened.Conclusion:For different types of anti⁃screening posi⁃tive patients,a quick blood transfusion protocol is necessory to protect patients with blood safety.

关 键 词：CD38单抗 不规则抗体 RH血型 自身抗体 交叉配血 

分 类 号：R457.1[医药卫生—治疗学]