微柱凝胶卡式法20例正反定型不符原因分析及对策  

Cause analysis and countermeasures of 20 cases of inconsistent positive and negative stereotypes by micro-column gel card method

作　　者：刘桂芳[1] 王薇薇[2] 王峻霞 韩霜[1] LIU Guifang;WANG Weiwei;WANG Junxia;HAN Shuang(Department of Blood Transfusion,Dongtai People's Hospital,Dongtai,224200,China;Department of Blood Transfusion,Dongtai Hospital of Traditional Chinese Medicine)

机构地区：[1]东台市人民医院输血科,江苏东台224200 [2]东台市中医院输血科

出　　处：《临床血液学杂志》2024年第2期113-116,122,共5页Journal of Clinical Hematology

摘　　要：目的:调查微柱凝胶卡式法ABO正反定型不符的原因,并探讨相应对策。方法:结合盐水介质试管法对微柱凝胶卡式法正反定型不符的患者,进行不同血型血清学试验:吸收放散试验、唾液中血型物质测定、直接抗球蛋白试验、不规则抗体筛选及鉴定以及临床资料进行综合分析。结果:4 578例血型资料中有20例正反定型不符。其中婴幼儿4例,抗原抗体减弱4例,亚型3例,不规则抗体2例,M蛋白2例,冷自身抗体2例,自身免疫性溶血性贫血2例,ABO不相合造血干细胞移植后1例。盐水试管法能纠正7例,其中婴幼儿3例,M蛋白2例,冷自身抗体2例。结论:卡式法结合试管法有利于纠正部分婴幼儿、冷自身抗体、M蛋白所致的正反定型不符;对试管法无法纠正的正反定型不符,结合多种血型血清学方法及患者临床资料等综合分析,有利于血型的最终判定。Objective: To investigate the reasons for the inconsistency of ABO positive and negative stereotypes by micro-column gel card method,and explore the corresponding countermeasures.Methods: Serological tests of different blood types were carried out in the cases with inconsistent positive and negative typing by saline medium test tube method:Absorption-elution test,determination of blood group substances in saliva,direct antiglobulin test,screening and identification of irregular antibodies and clinical data were analyzed comprehensively.Results: In 4578 cases of blood type data,20 cases of positive and negative stereotypes were inconsistent.Among them,there were 4 cases of infants and children,4 cases of antigen antibody weakening,3 cases of subtype,2 cases of irregular antibody,2 cases of M protein,2 cases of cold autoantibodies,2 cases of autoimmune hemolytic anemia,and 1 case after ABO incompatible hematopoietic stem cell transplantation.Saline test tube method could correct 7 cases,including 3 cases of infants,2 cases of M protein;and 2 cases of cold autoantibodies.Conclusion: The card method combined with the tube method might be helpful to correct the inconsistency of positive and negative stereotypes caused by some infants,cold autoantibodies and M protein.For the positive and negative stereotypes that could not be corrected by the test tube method,comprehensive analysis combined with many serological methods of blood group and clinical data of patients,etc.might be conducive to the final determination of blood group.

关 键 词：正反定型不符 微柱凝胶卡式法 盐水试管法 血型血清学 

分 类 号：R446.11[医药卫生—诊断学]