自身免疫性溶血性贫血影响血型鉴定及交叉配血结果的临床分析  

Clinical analysis of autoimmune hemolytic anemia influence on blood group identification and cross matching results

作　　者：张小乐 高志峰[1] Zhang Xiaole;Gao Zhifeng(Department of Transfusion,Anyang Regional Hospital,Puyang 455000,China)

机构地区：[1]濮阳市安阳地区医院输血科,濮阳455000

出　　处：《实用医技杂志》2024年第11期795-798,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨自身免疫性溶血性贫血(AIHA)患者进行输血时,对血型鉴定、交叉配血结果情况的影响。方法本研究属于回顾性分析,85例AIHA患者来源于濮阳市安阳地区医院,选取时间为2016年5月至2022年5月,所有患者均进行直接抗人球蛋白试验(DAT),并对患者血型进行鉴定,之后将供血者红细胞加受血者血浆,进行交叉配血试验。对AIHA抗人球蛋白试验结果进行分析,分析不同直接抗人球蛋白试验强度、抗体类型自身免疫性溶血性贫血患者血型鉴定、交叉配血的结果。结果本文所有患者中进行DAT后,结果呈现为阳性,强度为(+)~(++++),其中强度为++、+++的患者占比较高,分别为35.3%(30/85)、37.6%(32/85);所有患者间接抗人球蛋白试验结果均呈阳性,且强度为++、+++的患者占比较高,分别为34.1%(29/85)、32.9%(28/85);所有患者抗体类型以温抗体为主,占比80.0%(68/85),其次为混合抗体,占比11.8%(10/85),冷抗体占比最少,为8.2%(7/85);85例患者中,ABO血型正反定型不相符的有44例,占比51.8%,DAT强度和ABO血型正反定型不相符、交叉配血不相合的发生率成正比,DAT强度为++++的患者ABO血型正反定型不相符率、交叉配血不相合率比DAT强度为+、++、+++的患者占比高(P<0.05),冷抗体患者血型正反定型不相符率、交叉配血不相合率均相较于混合抗体、温抗体患者的占比上升,但差异无统计学意义(P>0.05),对温抗体血型正反定型不相符的患者进行了氯喹放散试验,结果显示为相符;抗体类型为冷抗体、混合抗体的患者经37℃加热之后进行氯喹放散试验,结果呈现为相符。结论AIHA患者抗体类型以温抗体居多,AIHA患者出现ABO血型正反定型不相符、交叉配血不相合的概率较高,应在AIHA患者输血前,进行抗人球蛋白试验、明确患者血型,并进行交叉配血试验,可有助于输血治疗有效性的提升。Objective To investigate the effect of blood transfusion on blood type identification and cross matching in patients with autoimmune hemolytic anemia(AIHA).Methods This study was a retrospective analysis.85 AIHA patients were from Anyang Regional Hospital,Puyang City,from May 2016 to May 2022.Anti-human globulin test was performed on all patients,and their blood types were identified.The results of AIHA anti-human globulin test were analyzed,and the results of blood group identification and cross matching in patients with autoimmune hemolytic anemia with different direct anti-human globulin test intensity and antibody types were analyzed.Results After direct anti-human globulin test in all patients,the results were positive with intensity ranging from+to++++,among which patients with intensity of++and+++accounted for a relatively high proportion,35.3%(30/85)and 37.6%(32/85),respectively.Indirect anti-human globulin test results were positive in all patients,and the patients with++and+++intensity accounted for a relatively high proportion,34.1%(29/85)and 32.9%(28/85),respectively.In all patients,warm antibodies were the main antibody type,accounting for 80.0%(68/85),followed by mixed antibodies,accounting for 11.8%(10/85),and cold antibodies accounted for the least,accounting for 8.2%(7/85).Among the 85 patients,44 cases were inconsistent with positive and negative ABO blood type,accounting for 51.8%.The incidence of positive and negative ABO blood type incompatibility and cross-matching incompatibility was positively correlated with DAT intensity.The incidence of positive and negative ABO blood type incompatibility and cross-matching incompatibility in patients with DAT intensity of++++was higher than that in patients with DAT intensity of+,++and+++(all P<0.05).The incompatibility rates of positive and negative blood type and cross matching blood type in cold antibody patients were higher than those in mixed antibody and warm antibody patients,but there was no significant difference(P>0.05 for all).Chloroquine re

关 键 词：溶血性贫血 自身免疫性 血型鉴定 交叉配血 影响 

分 类 号：R446.6[医药卫生—诊断学] R556.62[医药卫生—临床医学]