12例急性自身免疫性溶血性贫血患者体外溶血试验配血与输血研究
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摘要
本研究采用体外溶血试验配血方法,为微柱凝胶抗人球蛋白法配血困难的急性自身免疫性溶血性贫血(AIHA)患者筛查配血相容的红细胞。对照组选择26例AIHA患者,采用微柱凝胶抗人球蛋白法,确定配血结果凝集强度最弱的同型供血者红细胞输注。实验组为12例微柱凝胶抗人球蛋白法配血困难的急性AIHA患者,采用体外溶血试验配血法,选取配血结果出现不溶血的同型供血者红细胞输注。结果表明,体外溶血试验法输血组与微柱凝胶抗人球蛋白法配血组输血效果相比较,差异有显著性意义(P<0.01)。实验组患者平均每次输注去白细胞红细胞悬液2.26单位,输血后患者血红蛋白、网织红细胞及总胆红素等指标变化与输血前相比较,差异有显著性意义(P<0.01)。结论:在微柱凝胶抗人球法配血困难时,采取体外溶血试配血可以顺利为AIHA患者筛查到相容红细胞。
In order to screen the compatible red cells by using extracorporal hemolysis test for acute autoimmune hemolytic anemia(AIHA)patients who were difficult to be matched by automatic microcolumn gel indirect antiglobulin test.Twenty-six cases of AIHA were chosen as control groupto whom the same type of donor red blood cells were infused with the weakest blood agglutination12 cases of acute AIHA patients were chosen as test groupthese patients were difficult to be matched by automatic microcolumn gel indirect antiglobulin testand the donor red cells without hemolysis by extracoral hemolysis test were transfused for them.The results showed that compared with the control groupthe effect of transfusion was better in test group( P < 0.01),with 2.26 U leukocyte-depleted erythrocyte suspension in averagewhose hemoglobinreticulocyte and total bilirubin levels were changed significantly compared with those before blood tran-sfusion(P < 0.01).It is concluded that the compatible red blood cells for the acute AIHA patients can be screened by the extracorporal hemolysis testwhen it is diffcult to screen by the automatic microcolumn gel indirect antiglobulin test.
In order to screen the compatible red cells by using extracorporal hemolysis test for acute autoimmune hemolytic anemia(AIHA)patients who were difficult to be matched by automatic microcolumn gel indirect antiglobulin test.Twenty-six cases of AIHA were chosen as control groupto whom the same type of donor red blood cells were infused with the weakest blood agglutination12 cases of acute AIHA patients were chosen as test groupthese patients were difficult to be matched by automatic microcolumn gel indirect antiglobulin testand the donor red cells without hemolysis by extracoral hemolysis test were transfused for them.The results showed that compared with the control groupthe effect of transfusion was better in test group( P < 0.01),with 2.26 U leukocyte-depleted erythrocyte suspension in averagewhose hemoglobinreticulocyte and total bilirubin levels were changed significantly compared with those before blood tran-sfusion(P < 0.01).It is concluded that the compatible red blood cells for the acute AIHA patients can be screened by the extracorporal hemolysis testwhen it is diffcult to screen by the automatic microcolumn gel indirect antiglobulin test.
引文
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2 于洋,孙晓琳,马春亚,等.61例自身免疫性溶血贫血患者血型血清学特征及输血疗效评估.中国实验血液学杂志,2013;21(5):1275-1279.
3 李志强.溶血性贫血/李志强.现代血液病输血疗法.第1版,上海:上海医科大学出版社,1999:89-96.
4 郑琼珍,陈雨蔚,邓彩芳,等.26名AIHA患者的配血策略.中国输血杂志,2010;23(3):217-218.
5 兰炯采,刘景汉,马红丽.输血前试验中值得研讨的若干问题.中国输血杂志,2013;26(1):1-2.
6 原敏,唐聪海,甘玮玮,等.体外溶血试验配血救治急性溶血性贫血危象产妇的临床应用.中国实验血液学杂志,2014;22(4):1094-1098.
7 陈宏础,王鸿利.贫血的检查//叶应妩,王毓三,申子瑜.全国临床检验操作规程.第3版,南京:东南大学出版社,2006:164-196.
8 汪传喜,田兆嵩.自身免疫性溶血性贫血患者的输血前检查和成分输血/田兆嵩.临床输血进展.第一版,四川:四川科学技术出版社,2010:74-79.
2 于洋,孙晓琳,马春亚,等.61例自身免疫性溶血贫血患者血型血清学特征及输血疗效评估.中国实验血液学杂志,2013;21(5):1275-1279.
3 李志强.溶血性贫血/李志强.现代血液病输血疗法.第1版,上海:上海医科大学出版社,1999:89-96.
4 郑琼珍,陈雨蔚,邓彩芳,等.26名AIHA患者的配血策略.中国输血杂志,2010;23(3):217-218.
5 兰炯采,刘景汉,马红丽.输血前试验中值得研讨的若干问题.中国输血杂志,2013;26(1):1-2.
6 原敏,唐聪海,甘玮玮,等.体外溶血试验配血救治急性溶血性贫血危象产妇的临床应用.中国实验血液学杂志,2014;22(4):1094-1098.
7 陈宏础,王鸿利.贫血的检查//叶应妩,王毓三,申子瑜.全国临床检验操作规程.第3版,南京:东南大学出版社,2006:164-196.
8 汪传喜,田兆嵩.自身免疫性溶血性贫血患者的输血前检查和成分输血/田兆嵩.临床输血进展.第一版,四川:四川科学技术出版社,2010:74-79.