1例骨髓增生异常综合征多次受血患者血清存在抗-M,抗-cE和抗-Jkb抗体的鉴定及配血输血策略  

Identification and Transfusion Strategy of Anti-M,Anti-cE and Anti-Jkb Antibodies in the Serum of Patients with Myelodysplastic Syndromes Receiving Multiple Blood Transfusions

作　　者：张良子 左琴琴[1] 吴大洲[1] 褚晓月 毛娟[1] 张薇薇 王红[1] 徐华[1] ZHANG Liang-zi;ZUO Qin-qin;WU Da-zhou;CHU Xiao-yue;MAO Juan;ZHANG Wei-wei;WANG Hong;XU Hua(Blood Center of Shaanxi Province,Xi’an 710061,China)

机构地区：[1]陕西省血液中心,西安710061

出　　处：《现代检验医学杂志》2023年第1期195-198,共4页Journal of Modern Laboratory Medicine

基　　金：西安市科技计划项目(21YXYJ0085):输血中SGK1+T细胞通过AKT/mToRα信号通路诱发继发性哮喘的分子机制研究。

摘　　要：目的通过对临床送检的1例骨髓增生异常综合征(myelodysplastic syndrome,MDS)多次受血患者的抗筛阳性标本进行鉴定,探讨此类复杂不规则抗体的鉴定思路、方法及输血方案。方法鉴定标本ABO,Rh,MNS和Kidd等血型,应用2种谱细胞及筛选出的无偿献血者细胞配合吸收放散实验进行抗体筛查、复杂不规则抗体特异性鉴定,采用盐水法、凝聚胺法和间接抗球蛋白方法进行交叉配血。结果患者血型血清学结果为O,CCDee,M-N+和Jk(a+b-),其血清中检出Ig M-M,Ig G-c E和Ig G-Jk^(b)抗体,筛选M,c,E及Jkb抗原均为阴性的供血者与患者进行交叉配血,配血相合后进行输注。结论针对多次受血患者产生的复杂不规则抗体,应灵活运用灵敏度高的血清学方法,联合多种谱细胞,准确鉴定出抗体特异性,为临床提供相合的血液,有效保障输血的安全性。Objective To identify the anti-screening positive specimens of a patient with myelodysplastic syndrome(MDS)who received multiple blood samples,and explore the identification ideas,methods and transfusion schemes of such complex irregular antibodies.Methods Identified the ABO,Rh,MNS and Kidd blood groups,screened and identified the mixed irregular antibodies through absorption and elution test with various cell panels.Cross matching was performed by saline method,polyamine method and indirect antiglobulin method.Results The blood types were O,CCDee,M-N+,Jk(a+b-).Ig M-M,Ig G-c E and Ig G-Jk^(b)antibodies were detected in the serum of patients in control of the cell spectrum response pattern.The blood donors who were negative for M,c,E and Jkbantigens were selected for transfusion after cross matching.Conclusion For the identification of mixed irregular antibodies,should clarify the idea of identification,combine various cell panels,flexibly use of serological methods,effectively improve the ability of laboratory to solve difficult problems,provide compatible blood for clinical,and ensure blood transfusion safety.

关 键 词：骨髓增生异常综合征 抗-M 抗-Jkb 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R457.12[医药卫生—内科学]