微柱凝胶法输血相容性检测弱凝集现象的影响原因及应对策略  

The causes and countermeasures of weak agglutination in blood transfusion compatibility detection by microcolumn gel

作　　者：段晓旭 Duan Xiao-xu(Department of Blood Transfusion,Henan Hongli Hospital,Xinxiang 453400,Henan,China)

机构地区：[1]河南宏力医院输血科,河南新乡453400

出　　处：《四川生理科学杂志》2023年第9期1633-1636,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探究微柱凝胶法输血相容性检测弱凝集现象的影响原因及应对策略。方法:选取2020年9月-2022年12月经微柱凝胶法应用于ABO血型鉴定、交叉配血以及抗体筛查试验后表现为弱凝集的80例患者血标本作为研究对象。对研究对象进行增加血清量或红细胞、37℃洗涤红细胞、两次离心血清标本以及吸收放散试验等处理后,随后再使用间接抗人球蛋白法(Indirect antiglobulin test,IAT)及盐水法作对照检测。结果:在对80例患者的血标本进行微柱凝胶法检测其输血相容性后,凝集强度显示为1+^(w)~2+^(w)中,有19例(23.75%)ABO血型的抗原性较弱,有7例(8.75%)为ABO亚血型,有9例(11.25%)ABO血型的抗体效价较低,有15例(18.75%)纤维蛋白有所增高,有11例(13.75%)高效价冷凝激素,有19例(23.75%)自身免疫性抗体。在对80例患者的血标本进行微柱凝胶法检测其输血相容性中,出现55例(68.75%)ABO血型正反定型不相符,出现25例(31.25%)抗体筛选阳性。在交叉配血中出现不合的有49例(61.25%),其中包含28例(57.14%)抗体筛选为阳性,包含21例(42.86%)正反定型为不符合。结论:ABO血型的抗原性较弱、ABO亚血型、ABO血型的抗体效价较低、纤维蛋白有所增高以及自身免疫性抗体是影响微柱凝胶法发生弱凝集现象的相关因素。可在微柱凝胶法检测前,通过增加血清量或红细胞,37℃洗涤红细胞,对血清标本离心两次以及吸收放散试验等处理,能有效排除上述因素对发生弱凝集现象的干扰。Objective:To explore the causes and strategies of weak agglutination in blood transfusion compatibility detection by microcolumn gel method.Methods:From September 2020 to December 2022,blood samples of 80 patients who showed weak agglutination after ABO blood group identification,cross matching and antibody screening tests were selected as the study objects.The subjects were treated with increasingserum volume or red blood cells,washing red blood cells at 37℃,two centrifugation of serum samples,absorption and release test,and then Indirect antiglobulin test(IAT)and saline method were used for control detection.Result:After blood samples of 80 patients were tested for transfusion compatibility by microcolumn gel method,the agglutination intensity of 1+^(w)~2+^(w)showed that 19 cases(23.75%)of ABO blood group had weak antigenicity,7 cases(8.75%)of ABO subblood group,and 9 cases(11.25%)of ABO blood group had low antibody titer.There were 15 cases(18.75%)with increased fibrin,11 cases(13.75%)with high valence condensing hormone,and 19 cases(23.75%)with autoimmune antibody.In the blood samples of 80 patients tested by microcolumn gel method for transfusion compatibility,55 cases(68.75%)were found to be inconsistent with positive and negative ABO blood type,and 25 cases(31.25%)were found to be positive for antibody screening.There were 49 cases(61.25%)with incompatibility in cross-matching blood,including 28 cases(57.14%)with positive antibody screening and 21 cases(42.86%)with negative antibody screening.Conclusion:ABO blood group is weak antigenicity,ABO subblood group,ABO blood group antibody titer is low,fibrin is increased and autoimmune antibodies are the related factors affecting weak agglutination by microcolumn gel method.The interference of the above factors on weak agglutination can be effectively eliminated by increasing serum or red blood cells,washing red blood cells at 37℃,centrifuging serum samples twice,and absorption and release test before microcolumn gel detection.

关 键 词：微柱凝胶法 输血相容性 弱凝集现象 影响原因 间接抗人球蛋白法 ABO血型鉴定 37℃洗涤红细胞 

分 类 号：R44[医药卫生—诊断学]