一例类抗-Ec的鉴定分析附文献回顾  

Identification of mimicking anti-Ec with literature review:a case report

作　　者：余占娟 范亮峰 李婧薇 向东 YU Zhanjuan;FAN Liangfeng;LI Jingwei;XIANG Dong(Quzhou Blood Center,Quzhou 324000,China;Shanghai Blood Center,Shanghai 200051,China;Sichuan Provincial People′s Hospital,Chengdu 610072,China)

机构地区：[1]衢州市中心血站,浙江衢州324000 [2]上海血液中心,上海200251 [3]四川省人民医院,四川成都610072

出　　处：《中国输血杂志》2024年第11期1313-1317,共5页Chinese Journal of Blood Transfusion

基　　金：衢州市科技计划项目(ZD2022097)。

摘　　要：目的通过对1例类同种自身抗体的鉴定,分析其血清学特点、抗体特异性,探讨类抗体的输血策略。方法通过直抗试验、抗体鉴定、效价检测及吸收放散试验对患者进行抗体特异性鉴定,对以往文献进行回顾性分析。结果稀释后的血清和放散液均检出抗-Ec格局。患者抗体对应抗原阴性的献血者红细胞(O型,CCDee)吸收血清后放散出抗-Ec。血清与放散液中,用E阳性细胞检测效价均强于E阴性细胞,血清效价相差5~6管;放散液相差2管。回顾分析国内外30篇文献,发现类抗体分布以Rh血型系统为主,占86.4%;其次为Kidd、MNS、Duffy等血型系统。结论患者血清中存在类抗-Ec。该类抗体中有特异性明显的类抗-E以及特异性不明显的类抗-E,合理利用效价、吸收放散等方法,有助于类抗体特异性的鉴定,为临床输血提供输血策略。Objective To identify a mimicking alloantibody,analyze its serological characteristics and antibody specificity,and explore transfusion strategies for mimicking alloantibody.Methods The antibody specificity of patients was identified by direct anti-globulin test,antibody identification,antibody titration test and absorption-elution test.Related literature was retrospectively reviewd.Results The anti-Ec was detected in both the diluted serum and elution liquid.The patient′s antibody corresponded to antigen negative red blood cells(type O,CCDee)from blood donors who absorb serum and elute anti-Ec.In both serum and elution liquid,the titer detected by E-positive cells was stronger than that by E-negative cells,with a difference of 5-6 tubes in the serum and a difference of 2 tubes in the elution liquid.Thirty articles at home and abroad were reviewed and analyzed,revealing that the distribution of mimicking specificity autoantibodies was mainly in the Rh blood group system,accounting for 86.4%,followed by blood type systems such as Kidd,MNS,Duffy,etc.Conclusion The presence of mimicking anti-Ec antibody in the patient′s serum was confirmed,with specific and non-specific anti-E antibodies in the mimicking antibody.Reasonable use of antibody titer test,and absorption-elution test can help identify the specificity of anti-E antibodies and provide transfusion strategies for clinical transfusion.

关 键 词：类抗体 类抗体效价 交叉配血 

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