低效价抗体致溶血性输血反应的相关分析  

Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody

作　　者：罗圆圆 马春娅 付丽辉 杨鑫 于洋 汪德清 LUO Yuan-Yuan;MA Chun-Ya;FU Li-Hui;YANG Xin;YU Yang;WANG De-Qing(Department of Transfusion Medicine,The First Medical Center of PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心输血医学科,北京100853

出　　处：《中国实验血液学杂志》2023年第2期503-508,共6页Journal of Experimental Hematology

摘　　要：目的:建立低效价血型抗体在溶血性输血不良反应发生中的诊断流程。方法:应用酸放散试验、酶法和PEG法进行抗体鉴定试验,结合患者临床症状及相关检查指标,检测患者血浆中是否存在导致溶血的不规则抗体。结果:患者不规则抗体筛查阳性,血清中确定存在抗-Le^(a)抗体,发生输血反应后,使用增强试验检测到低效价抗-E抗体,患者Rh分型为Ccee,所输注红细胞为ccEE,患者新、旧标本用PEG方法与所输红细胞配血,主侧均不相合,找到溶血性输血反应发生的证据。结论:血清中低效价的抗体不易被检出,往往会导致患者发生严重的溶血性输血反应。Objective:To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion.Methods:Acid elusion test,enzyme method and PEG method were used for antibody identification.Combined with the patient′s clinical symptoms and relevant inspection indexes,the irregular antibodies leading to hemolysis were detected.Results:The patient's irregular antibody screening was positive,and it was determined that there was anti-Le^(a) antibody in the serum.After the transfusion reaction,the low titer anti-E antibody was detected by enhanced test.The patient's Rh typing was Ccee,while the transfused red blood cells were ccEE.The new and old samples of the patient were matched with the transfused red blood cells by PEG method,and the major were incompatible.The evidence of hemolytic transfusion reaction was found.Conclusion:Antibodies with low titer in serum are not easy to be detected,which often lead to severe hemolytic transfusion reaction.

关 键 词：低效价 不规则抗体 溶血性输血反应 增强试验 

分 类 号：R457.13[医药卫生—治疗学]