17例自身免疫性溶血性贫血血型鉴定和交叉配血的临床分析
|
摘要
目的:探讨自身免疫性溶血性贫血(AIHA)患者输血前检查的干扰因素与解决方法,及时为AIHA患者提供安全、可靠的血液。方法:选取本院2015年1月-2017年12月收治的17例AIHA患者为研究对象,分别进行ABO/RhD血型鉴定和交叉配血实验,对出现ABO正反定型不一致和交叉配血不相合的患者进行吸收放散等方法处理。结果:17例AIHA患者中7例出现ABO血型正反不符,经吸收放散等方法处理后恢复一致;10例出现交叉配血不合,其中9例患者成功找到相合血液,1例失败。结论:运用吸收放散等方法能有效降低自身抗体对AIHA患者血型鉴定和交叉配血的干扰,提高血型鉴定和交叉配血的准确性。
Objective:To explore the interference factors and solutions of patients with autoimmune hemolytic anemia(AIHA) before blood transfusion,and provide safe and reliable blood for AIHA patients in time.Method:A total of 17 patients with AIHA in our hospital from January 2015 to December 2017 were selected as the research subjects.They were studied and conducted ABO/RhD blood grouping and cross matching tests respectively.Patients with inconsistent positive and negative ABO typing and inconsistent cross matching were treated by absorption and emission experiment.Result:Among 17 patients with AIHA,7 cases of ABO blood group appeared positive or negative,and recovered by absorption and dispersion.10 cases of incompatibility of cross matching,9 cases of them successfully found matching blood,1 case failed.Conclusion:Absorption and emission and other methods can effectively reduce the interference of autoantibodies on AIHA blood group identification and cross matching,and improve the accuracy of blood group identification and cross matching.
Objective:To explore the interference factors and solutions of patients with autoimmune hemolytic anemia(AIHA) before blood transfusion,and provide safe and reliable blood for AIHA patients in time.Method:A total of 17 patients with AIHA in our hospital from January 2015 to December 2017 were selected as the research subjects.They were studied and conducted ABO/RhD blood grouping and cross matching tests respectively.Patients with inconsistent positive and negative ABO typing and inconsistent cross matching were treated by absorption and emission experiment.Result:Among 17 patients with AIHA,7 cases of ABO blood group appeared positive or negative,and recovered by absorption and dispersion.10 cases of incompatibility of cross matching,9 cases of them successfully found matching blood,1 case failed.Conclusion:Absorption and emission and other methods can effectively reduce the interference of autoantibodies on AIHA blood group identification and cross matching,and improve the accuracy of blood group identification and cross matching.
引文
[1]陆小亚,吴涛,代湘云,等.自身免疫性溶血性贫血合并铁粒幼细胞贫血一例[J].中国医师进修杂志,2016,39(11):1035-1036.
[2]乔晓媛,牛润桂,魏淑青.中晚期肺癌患者化疗前后的CD4+CD25+调节性T细胞含量变化及其作用研究[J].中国药物与临床,2015,15(5):680-682.
[3]张秋会,胡兴斌,孙文利,等.免疫性疾病患者输血前血型血清学特征分析[J].国际输血及血液学杂志,2016,39(4):299-304.
[4]夏荣,张琦,陈勤奋.自身免疫性溶血性贫血患者输血前试验及临床输血专家共识[J].中国输血杂志,2017,30(7):663-665.
[5]姚丽,王忱.温自身抗体的相关输血对策[J].临床血液学杂志(输血与检验),2016,29(4):675-676.
[6]方春富,何智.IgM抗-M在37℃出现溶血反应合并自身冷抗体1例[J].中国输血杂志,2013,26(11):1145-1146.
[7]谢霞,张勇萍,杨世明,等.13例高球蛋白血症对ABO血型鉴定和交叉配血结果的干扰及处理方法[J].细胞与分子免疫学杂志,2017,33(6):835-837.
[8]黄海东,李婉红,王丽阳,等.Rh血型系统类抗体在临床输血中的检测与研究[J].中国卫生检验杂志,2016,26(1):62-63.
[9]庞卫花,徐娜,杨敬芳,等.ABO血型正反定型与交叉配血实验结果及影响因素分析[J].河北医药,2016,38(9):1366-1368.
[10]李英,夏伟红.高效价自身冷抗体致血型鉴定和交叉配血困难的有效处理[J].临床研究,2016,24(2):192.
[11]夏小军,段赟.中医药治疗自身免疫性溶血性贫血的思路与方法[J].西部中医药,2016,29(2):41-44.
[12]谢一唯,李育,陈秉宇.糖皮质激素与洗涤红细胞输注联合治疗AIHA的疗效观察[J].浙江医学,2016,38(16):1348-1350.
[13]刘景兰,冯道营.自身免疫性溶血性贫血的输血治疗[J].中国小儿血液与肿瘤杂志,2001,6(4):179-180.
[14]兰炯采.自身免疫性溶血性贫血患者的配血试验[J].中国输血杂志,2015,28(7):753-754.
[15]徐晓玲,黄琳珊.血型鉴定及交叉配血困难1例报道[J].现代医药卫生,2014,30(22):3514.
[16]刘红冰,兰炯采,李艳英,等.自身免疫性溶血性贫血患者ABO血型鉴定及抗体筛查[J].中国输血杂志,2017,30(8):953-954.
[17]李志强.诠释温抗体型AIHA血型血清学检测路径分析与输血原则[J].中国输血杂志,2014,27(11):1161-1162.
[18]余柳翠.自身免疫性溶血性贫血患者交叉配血不合与试验研究[J/OL].中西医结合心血管病电子杂志,2016,4(26):23-24.
[19]张秋会,孙文利,胡兴斌,等.AIHA患者血清中类同种特异性自身抗体的检出率及其分布情况探讨[J].中国输血杂志,2016,29(12):1352-1355.
[20]袁文声,易峰,何锐洪,等.自身免疫性溶血性贫血患者的类同种自身抗体检测及其输血对策探讨[J].实验与检验医学,2015,33(4):403-404,409.
[2]乔晓媛,牛润桂,魏淑青.中晚期肺癌患者化疗前后的CD4+CD25+调节性T细胞含量变化及其作用研究[J].中国药物与临床,2015,15(5):680-682.
[3]张秋会,胡兴斌,孙文利,等.免疫性疾病患者输血前血型血清学特征分析[J].国际输血及血液学杂志,2016,39(4):299-304.
[4]夏荣,张琦,陈勤奋.自身免疫性溶血性贫血患者输血前试验及临床输血专家共识[J].中国输血杂志,2017,30(7):663-665.
[5]姚丽,王忱.温自身抗体的相关输血对策[J].临床血液学杂志(输血与检验),2016,29(4):675-676.
[6]方春富,何智.IgM抗-M在37℃出现溶血反应合并自身冷抗体1例[J].中国输血杂志,2013,26(11):1145-1146.
[7]谢霞,张勇萍,杨世明,等.13例高球蛋白血症对ABO血型鉴定和交叉配血结果的干扰及处理方法[J].细胞与分子免疫学杂志,2017,33(6):835-837.
[8]黄海东,李婉红,王丽阳,等.Rh血型系统类抗体在临床输血中的检测与研究[J].中国卫生检验杂志,2016,26(1):62-63.
[9]庞卫花,徐娜,杨敬芳,等.ABO血型正反定型与交叉配血实验结果及影响因素分析[J].河北医药,2016,38(9):1366-1368.
[10]李英,夏伟红.高效价自身冷抗体致血型鉴定和交叉配血困难的有效处理[J].临床研究,2016,24(2):192.
[11]夏小军,段赟.中医药治疗自身免疫性溶血性贫血的思路与方法[J].西部中医药,2016,29(2):41-44.
[12]谢一唯,李育,陈秉宇.糖皮质激素与洗涤红细胞输注联合治疗AIHA的疗效观察[J].浙江医学,2016,38(16):1348-1350.
[13]刘景兰,冯道营.自身免疫性溶血性贫血的输血治疗[J].中国小儿血液与肿瘤杂志,2001,6(4):179-180.
[14]兰炯采.自身免疫性溶血性贫血患者的配血试验[J].中国输血杂志,2015,28(7):753-754.
[15]徐晓玲,黄琳珊.血型鉴定及交叉配血困难1例报道[J].现代医药卫生,2014,30(22):3514.
[16]刘红冰,兰炯采,李艳英,等.自身免疫性溶血性贫血患者ABO血型鉴定及抗体筛查[J].中国输血杂志,2017,30(8):953-954.
[17]李志强.诠释温抗体型AIHA血型血清学检测路径分析与输血原则[J].中国输血杂志,2014,27(11):1161-1162.
[18]余柳翠.自身免疫性溶血性贫血患者交叉配血不合与试验研究[J/OL].中西医结合心血管病电子杂志,2016,4(26):23-24.
[19]张秋会,孙文利,胡兴斌,等.AIHA患者血清中类同种特异性自身抗体的检出率及其分布情况探讨[J].中国输血杂志,2016,29(12):1352-1355.
[20]袁文声,易峰,何锐洪,等.自身免疫性溶血性贫血患者的类同种自身抗体检测及其输血对策探讨[J].实验与检验医学,2015,33(4):403-404,409.