多凝集红细胞对输血检测的影响和对策  

Impact and Countermeasures of Polyagglutinated Erythrocytes on Blood Transfusion Detection

作　　者：李彩平 杨红梅[3] 范小杰[4] Li Caiping;Yang Hongmei;Fan Xiaojie(Department of Blood Transfusion,Wujin Hospital Affiliated to Jiangsu University,Changzhou 213000,Jiangsu Province,China;Department of Blood Transfusion,Wujin Clinical College of Xuzhou Medical University,Changzhou 213000,Jiangsu Province,China;Transfusion Research Laboratory,Changzhou Blood Center,Changzhou 213004,Jiangsu Province,China;Department of Clinical Laboratory,the First People's Hospital of Changzhou,Changzhou 213004,Jiangsu Province,China)

机构地区：[1]江苏大学附属武进医院输血科,江苏常州213000 [2]徐州医科大学武进临床学院输血科,江苏常州213000 [3]常州市中心血站输血研究室,江苏常州213004 [4]常州市第一人民医院检验科,江苏常州213004

出　　处：《中外医药研究》2023年第20期6-8,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：江苏省输血协会英科新创科研基金(编号:JSYK2023018);常州市科技局项目(编号:CJ20220240)。

摘　　要：目的:探讨多凝集红细胞在输血相容性检测中,ABO血型鉴定、交叉配血过程中的影响及应对策略。方法:回顾性分析2020年4月—2022年12月实验室检测的7例多凝集红细胞患者临床资料。通过ABO血型鉴定、直接抗人球蛋白试验、不规则抗体筛查、木瓜酶处理、吸收放散实验、花生水和双花扁豆水实验、唾液ABH血型物质及SSP-PCR基因分型等实验对多凝集红细胞特点进行分析。结果:患者1、2、4血型正反不符,吸收放散以及唾液酸实验结果证实患者1、2为O型,患者4为B型;患者2血清中合并抗-Lea抗体;患者7合并抗-CD38单抗治疗药物干扰;7例患者均为T/Tn抗原暴露引起的红细胞多凝集。结论:多凝集红细胞抗原是比较特殊的红细胞抗原,运用血清学联合植物凝集素实验能够鉴别多凝集红细胞,结合患者病史以及分子生物学方法,才能准确鉴定患者血型和交叉配血不合原因。Objective:To explore the impact and countermeasures of ABO blood type identification and cross matching in the test of blood transfusion compatibility of polyagglutinated erythrocytes.Methods:The clinical data of 7 patients with polyagglutinated erythrocytes detected by laboratory were retrospectively analyzed from April 2020 to December 2022.ABO blood group identification,direct anti-human globulin test,irregular antibody screening,papain enzyme treatment,absorption and release test,peanut water and double flower lentil water test,saliva ABH blood group material and SSP-PCR genotyping were used to analyze the characteristics of polyagglutinated erythrocytes.Results:The positive and negative blood groups of patients 1,2 and 4 were inconsistent,and the absorption,release and sialic acid test results confirmed that patients 1 and 2 were type O and patient 4 was type B.The patient 2 was combined with anti-Lea antibody.Patient 7 combined with anti-CD38 single antibody treatment drug interference;T/Tn antigen exposure caused erythrocyte polyagglutination in all 7 patients.Conclusion:Polyagglutinated erythrocyte antigen is relatively special erythrocyte antigens.Serology combined with phytoagglutinin test can identify and distinguish polyagglutinated erythrocytes.Only by combining patient history and molecular biological methods can we accurately identify the causes of blood type and cross-matching incompatibility of patients.

关 键 词：多凝集红细胞 抗体鉴定 交叉配血 

分 类 号：R44[医药卫生—诊断学]