受血者ABO血型正反定型不符的循证分析

Causes of discrepancies of ABO blood group typing in blood transfusion patients

目的研究分析受血者ABQ血型正反定型不相符的原因。方法应用ABO血型正反定型试验、意外抗体鉴定、直接抗人球蛋白试验、红细胞吸收一放散试验及唾液血型物质检测等方法，确定受血者ABQ血型正反定型不相符的原因。结果12例受血者ABO血型正反定型不相符的原因包括实验者操作误差1例；血型抗体减弱或缺失4例；血浆蛋白异常3例；亚型和红细胞抗原减少2例；意外抗体干扰1例；血型不合造血干细胞移植后的嵌合状态1例。结论当受血者的ABO血型正反定型不相符时，必须进行复检和一系列确认试验。明确原因。从而保证临床用血安全。

Objective To analyze the causes of discrepancies of ABO forward and reverse grouping in blood transfusion patients. Methods The discrepancies of ABO blood group typing in 12 patients receiving blood transfusion were analyzed by using ABO blood group typing, unexpected antibodies identification, directly anti-globulin test, red cell absorb-elution test and salivary antigens test. Results The factors causing discrepancies of ABO blood group typing in 12 patients were errors in opera- tion in 1 case, antibodies decrease or absence in 4 cases, abnormal plasma protein in 3 cases, ABO subgroups or antigens de- crease in 2 cases, unexpected antibody in 1 case and chimera after hematogenous stem cell transplant in 1 case. Conclusion For safety of blood transfusion, when the ABO forward and reverse grouping are discrepant procedures should be repeated to find out the possible causes.