抗-E、抗-Lea合并抗-Jkb、抗-Cw致疑难配血及输血反应分析

Analysis of complicated blood matching and transfusion reaction caused by anti-E,anti-Lea combined with anti-Jkb,anti-Cw

探讨交叉配血中抗-E、抗-Lea合并抗-Jkb、抗-Cw抗体引起患者配血不合及输血反应原因。通过试管法鉴定ABO血型,毛细管离心法抗原分型和直接抗人球蛋白试验,盐水、聚凝胺、抗人球蛋白三种介质联用多套谱细胞进行抗体筛选试验及抗体特异性鉴定试验对患者配血不合进行分析。对照谱细胞格局表采用剂量效应,该患者血清中检出抗-E、抗-Lea合并抗-Jkb、抗-Cw,酸放散液中检出抗-E和抗-Jkb抗体。患者血清中多种不规则抗体是导致交叉配血不合的主要原因,该患者连续多次输注E抗原阳性及Jkb阳性红细胞是引起输血反应的主要原因,多抗体联合存在时应运用剂量效应以减少易漏检抗体概率,保证输血安全性。

To investigate the reason of anti-E,anti-Lea combined with anti-Jkb,anti-Cw inducing incompatibility in blood crossmatching and blood transfusion reaction.The blood mismatch of patients was analyzed through ABO blood group typing,blood group typing by capillary centrifugation and direct coombs testing,antibody screening test and antibody specificity identification test using saline,polycoagulant and anti-human globulin combined with multiple sets of panel cells.The dose-effect grading system was used to compare the pattern of cell spectra,which existed anti-E,anti-Lea combined with anti-Jkb antibodies in the serum of this patient,anti-Cw could be excluded.Anti-E and anti-Jkb antibodies were detected in acid release fluid.The presence of irregular antibodies in the serum of patients was the main factor leading to incompatibility in blood crossmatching.Continuous infusion of E antigen positive and Jkb positive red blood cells was the main cause of blood transfusion reaction.Applying the dose-effect combined antibodies could reduce the probability of missing weak antibodies and ensure the safety of clinical transfusion.