基层医院对罕见意外抗体的鉴定思路与试验方法探讨  

Identification and test methods of rare unexpected antibodies in grassroots medical institutions

作　　者：李勋[1] 宋栀娴 艾红梅[1] 李俊立[1] LI Xun;SONG Zhixian;AI Hongmei;LI Junli(Department of Blood Transfusion,Jingzhou Central Hospital/Research Institute of Blood Transfusion,Yangtze University,Jingzhou 434020,China)

机构地区：[1]荆州市中心医院输血科/长江大学输血研究所,湖北荆州434020

出　　处：《中国输血杂志》2024年第9期1073-1076,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨基层医院输血科如何利用现有资源,采用常规血清学方法对罕见意外抗体进行鉴定提供思路。方法选择本院就诊的1名血型正反定型不一致、抗体初筛阳性、常规配血不合的消化道出血患者为研究对象,采用混合人源O细胞吸收法进行血型鉴定,使用常规10系谱细胞抗体鉴定、凝聚胺法抗体鉴定、2-巯基乙醇(2-ME)试验、盲配、家系调查等方法了解抗体特性。结果患者血清学试验结果:1)血型为B型、RhD阳性,直接抗人球蛋白试验呈阴性;2)抗体性质为IgM型;3)抗-s、抗-Fya、抗-k可能性小,复合抗体不能排除;4)患者血液标本与20名供者的血液标本交叉配血试验主侧不合,与同系3个姐妹的血液标本交叉配血试验主侧均相合。结论倾向推断患者血浆中含有高频抗原系列抗体,无法鉴定时,可经家系调查寻找到相合血源进行辐照、输注。Objective To explore how to identify rare unexpected antibodies using routine serology methods in blood transfusion department of grassroots hospitals.Methods A patient with gastrointestinal bleeding with inconsistent forward and reverse blood typing,positive antibody screening and incompatible blood matching in our hospital was selected as the research object.Mixed human O cell absorption method was used for blood type identification,and 10-panel reagent red blood cells,manual polybrene test,2-mercaptoethanol(2-ME)test,blind match and pedigree study were used to explore the antibody characteristics.Results The serological test results of the patient′s serum were as follows:The blood group was type B and RhD positive,and negative for direct antiglobulin test;The antibody was IgM;The likelihood of this antibody being anti-s,anti-Fya or anti-k was low,and compound antibodies could not be excluded;The blood of the patient did not match with blood samples of 20 blood donors in the major side,while it matched with all the blood samples of her three sisters.Conclusion When the antibodies of high-prevalence antigen series in plasma cannot be identified,the matched blood may be found tthrough family survey for irradiation and transfusion.

关 键 词：意外抗体 家系调查 高频抗原系列 辐照 

分 类 号：R457.11[医药卫生—治疗学] S852.43[医药卫生—临床医学]