滨州市无偿献血者血液标本ABO血型正反定型结果不符的调查及原因分析  

Investigation and analysis of inconsistent results of ABO blood group forward and reverse typing of blood samples from voluntary blood donors in Binzhou City

作　　者：刘艳红 朱和鸣 原志飞 Liu Yanhong;Zhu Heming;Yuan Zhifei(Binzhou Blood Center,Binzhou 256600,Shandong Province,China;Binzhou Maternal and Child Health Hospital,Binzhou 256600,Shandong Province,China)

机构地区：[1]滨州市中心血站,滨州256600 [2]滨州市妇幼保健院,滨州256600

出　　处：《国际输血及血液学杂志》2024年第3期273-276,F0003,共5页International Journal of Blood Transfusion and Hematology

摘　　要：目的探讨滨州市无偿献血者血液标本ABO血型正、反定型结果不符(以下简称"正反定型不符")的原因。方法选择2021年1月至2022年12月滨州市中心血站采集的82745例无偿献血者全血标本为研究对象。献血者年龄为18~55岁,男、女性献血者分别为43398和39347例。采用血型血清学方法对血液标本进行ABO血型正反定型试验。正反定型结果不符时,先进行试管法复核;若正反定型结果仍为不符,则将血液标本送本站血型研究室进行血型确认试验。血型确认试验主要包括盐水介质试管法、吸收放散试验、不规则抗体筛选和鉴定试验。根据血型确认结果,对引起正反定型不符的原因进行分析。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求,并且于献血前与所有献血者签署《献血者知情同意书》。结果①本组82745例无偿献血者血液标本中,正反定型不符发生率为0.031%(26/82745),男、女性献血者血液标本正反定型结果不符发生率比较,差异无统计学意义[0.021%(9/43398)比0.043%(17/39347);χ^(2)=3.32,P=0.069]。②导致本研究26例血液标本正反定型不符的原因包括非特异性抗体、特异性意外抗体、ABO亚型、抗原减弱、抗体缺失或者减少,占比分别为42.3%(11/26)、26.9%(7/26)、15.4%(4/26)、7.7%(2/26)、7.7%(2/26)。③本站血型研究实验室对这26例血液标本的处理方法包括:增加血型定型试验中血清或血浆标本量,改变反应温度或者延长反应时间,吸收放散试验,以及增加抗-A1、抗-AB、抗-H标准血清检测。结论无偿献血者血液标本正反定型不符的原因复杂,可针对原因选择不同的处理方法确认标本ABO血型。ObjectiveTo explore reasons for inconsistency between forward and reverse ABO blood group typing(hereinafter referred to as forward and reverse typing inconsistency)of blood samples from voluntary blood donors in Binzhou City.MethodsFrom January 2021 to December 2022,a total of 82745 blood samples collected from voluntary blood donors in Binzhou Blood Center were selected as research subjects.The age of blood donors ranged from 18 to 55 years old.There were 43398 male and 39347 female blood donors.ABO blood group forward and reverse typing tests were performed on blood samples using blood group serology tests.If the forward and reverse typing were inconsistent,the test tube method was used for verification first.If the results of test tube method were still inconsistent,the blood samples were sent to blood typing laboratory for blood typing confirmation tests.Blood type confirmation tests mainly included saline medium test tube method,absorption-elution test,irregular antibody screening and identification test.The reasons for forward and reverse typing inconsistency were analyzed,according to results of ABO blood group confirm test results.The procedures followed in this study were in accordance with the requirements of the World Medical Association Declaration of Helsinki revised in 2013.And the Informed Consent of Blood Donors were signed with all blood donors before donation.Results①Among 82745 blood samples from voluntary blood donors in this study,the incidence of forward and reverse typing inconsistency was 0.031%(26/82745).There was no significant difference in the incidence of forward and reverse typing inconsistency between blood samples from male and female blood donors[0.021%(9/43398)vs 0.043%(17/39347);χ^(2)=3.32,P=0.069].②The reasons for forward and reverse typing inconsistency of 26 blood samples in this study included non-specific antibodies,specific unexpected antibodies,ABO subtypes,weakened antigen,and absence or reduction of antibodies,accounting for 42.3%(11/26),26.9%(7/26),15.4%(4/26),7.

关 键 词：ABO血型系统 血清学试验 血型抗原 无偿献血者 ABO血型正反定型 不规则抗体 

分 类 号：R446.6[医药卫生—诊断学]