Rh和Kidd抗体引起溶血性输血反应的血清学探究  

Serological characteristics of hemolytic transfusion reactions caused by Rh and Kidd antibodies

作　　者：曾群娟 杨贺才[2] 李西 钱昱霖 焦鑫[1] ZENG Qunjuan;YANG Hecai;LI Xi;QIAN Yulin;JIAO Xin(Dazhou Central Hospital,Dazhou 635000,China;Henan Red Cross Blood Center,Zhengzhou 450000,China)

机构地区：[1]达州市中心医院,四川达州635000 [2]河南省红十字血液中心,河南郑州450000

出　　处：《中国输血杂志》2025年第4期551-556,共6页Chinese Journal of Blood Transfusion

基　　金：河南省医学科技攻关计划项目(LHGJ20220260)。

摘　　要：目的回顾性分析Rh和Kidd抗体引起溶血性输血反应的血清学特点,为临床安全、及时、有效输血提供参考。方法选取达州市中心医院发生的2例RhCcEe和Kidd异型输血后的患者标本,对其进行输血实验室免疫血液学血清学试验,包含ABO、RhCcDEe和Kidd血型鉴定、意外抗体筛查和鉴定、交叉配血、直接抗人球蛋白试验、酸放散试验、毛细管离心技术分离患者自身红细胞和输入红细胞等。结果2例患者标本意外抗体筛查、抗体鉴定、直接抗球蛋白试验均阳性。病例1血浆中检出抗-Jkb,放散液中未检出特异性抗体。病例2血浆中检出抗-E、c,红细胞放散液中检出抗-E。高速毛细管离心,2例血液标本远心端均检出相应抗原阳性红细胞。结论病例1输入Kidd异型红细胞,病例2输入RhCcEe异型红细胞,2名患者均产生相应同种意外抗体,导致免疫性溶血性输血反应的发生。Objective To retrospectively analyse the serological characteristics of hemolytic transfusion reactions caused by Rh and Kidd antibodies,and to provide reference for safe,timely,and effective blood transfusion.Methods Two cases of patients with RhCcEe and Kidd blood type who experienced allogeneic transfusion at Dazhou Central Hospital were selected.A series of immunohematological tests were performed,including ABO,RhDCcEe and Kidd blood typing,unexpected antibody screening and identification,crossmatching,direct antiglobulin test,acid elution test,and capillary centrifugation to separate the patient′s own red blood cells from donated red blood cells.Results Unexpected antibody screening,antibody identification,and direct antiglobulin test were positive in both patients.Case 1 had anti-Jk b in the plasma,but no specific antibodies were found in the eluate.Case 2 had anti-c and E in the plasma,and anti-E was detected in the eluate.High-speed capillary centrifugation revealed corresponding antigen-positive erythrocytes at the distal end of the blood samples of both patients.Conclusion Case 1 received Kidd allogeneic red blood cells,and case 2 received RhCcEe allogeneic red blood cells,and both patients developed the corresponding unexpected antibodies,which led to the occurrence of immune haemolytic blood transfusion reaction.

关 键 词：异型输血 意外抗体 混合视野 溶血性输血反应 

分 类 号：R457.11[医药卫生—治疗学]