多发性骨髓瘤患者输血相容性检测结果及其干扰因素的处理措施  

Treatment measures for transfusion compatibility test results and interfering factors in patients with multiple myeloma

作　　者：霍琳红[1] 谭莉莎 赵薇 周颖[1] 夏秀明 程显娥 毕慧芳[1] 卢发强[1] HUO Linhong;TAN Lisha;ZHAO Wei;ZHOU Ying;XIA Xiuming;CHENG Xian'e;BI Huifang;LU Faqiang(Department of Blood Transfusion,Affiliated Zhongshan Hospital of Dalian University,Dalian,116001,China;Department of Clinical Laboratory,Dalian Women and Children's Medical Group)

机构地区：[1]大连大学附属中山医院输血科,辽宁大连116001 [2]大连市妇女儿童医疗中心(集团)检验科

出　　处：《临床血液学杂志》2024年第6期380-383,389,共5页Journal of Clinical Hematology

摘　　要：目的研究多发性骨髓瘤患者(MM)输血相容性检测结果对其干扰因素采取相应的处理措施。方法选择2021年12月—2023年12月医院收治的26例MM患者为研究对象,经输血相容性检测并分析结果,通过盐水置换法、凝聚胺试验、2巯基乙醇(2-Me)预处理红细胞等方法,处理相容性检测中遇到的干扰因素。结果26例MM患者输血相容性检测结果中,3例因蛋白凝聚干扰,处理措施:盐水置换法;11例患者因接受了CD38单抗类药物治疗干扰,处理措施:不规则抗体筛查红细胞可以用2-Me预处理,交叉配血试验可用凝聚胺法;2例患者存在抗-E抗体干扰,处理措施:选择E抗原阴性的红细胞输注;1例为冷凝集素干扰血型鉴定,处理措施:37℃孵育15 min后正反定型相符,26例MM患者多次接受输血治疗,无不良输血反应。结论MM患者输血相容性检测可通过这些处理措施的不断强化和完善,加强输血的质量和安全。输血实验室可根据具体情况制定工作流程,结合检验科、病理科相关项目检查报告,并与临床医生建立有效沟通模式,为人们的输血安全保驾护航。Objective To study the interference factors of transfusion compatibility test results in patients with multiple myeloma(MM)and take corresponding treatment measures.Methods A total of 26 MM patients admitted to our hospital from December 2021 to December 2023 were selected as the research subjects.After blood transfusion compatibility testing and analysis of the results,interference factors encountered in compatibility testing were treated using methods such as saline replacement,polyamine test and 2-Me pretreatment of red blood cells.Results Among the 26 cases of MM patients,3 cases were treated with saline replacement method due to protein coagulation interference;11 patients received interference from CD38 monoclonal antibody therapy,and the treatment measures were as follows:irregular antibody screening red blood cells could be pre treated with 2-Me,and cross matching tests could be performed using the polyamine method;Two patients had interference from anti E antibodies,and the treatment measures were as follows:infusion of red blood cells with negative E antigens;One case was caused by interference of cold agglutinin in blood type identification.Treatment measures:After incubation at 37℃for 15 minutes,the positive and negative typing matched.26 cases of MM patients received multiple transfusion treatments without any adverse transfusion reactions.Conclusion The transfusion compatibility test of MM patients could enhance the quality and safety of blood transfusion through the continuous strengthening and improvement of these treatment measures.The blood transfusion laboratory could formulate a workflow according to the specific situation,combine the inspection reports of relevant items of the laboratory department and the pathology department,and establish an effective communication mode with clinicians to escort the safety of people's blood transfusion.

关 键 词：多发性骨髓瘤 输血相容性检测 蛋白凝聚 CD38单抗 2巯基乙醇 

分 类 号：R733.3[医药卫生—肿瘤]