Evan′s综合征患者输血前血清学试验结果分析与输血策略探讨

Study on pretransfusion testing and transfusion strategy in Evan′s syndrome patients

目的分析Evan′s综合征患者输血前的血清学试验结果,探讨该类患者的输血策略。方法根据患者红细胞直接抗球蛋白分型试验结果,选择热放散或氯喹放散法,将放散后的红细胞进行ABO和Rh血型定型,并与自身血清进行吸收试验。热放散液或吸收处理后的血清进行抗体筛选和鉴定试验。根据抗体鉴定结果选择合适的血液,分别采用盐水法、聚凝胺法、LISS/Coomb′s凝胶卡法进行主侧交叉配血试验;对比患者输血前后的血红蛋白,以判定输血效果。结果患者血型均得到正确定型;检出抗-E 2例、抗-S 1例,1例抗体特异性未明确;交叉配血结果相合,输血效果理想。结论 Evan′s综合征患者的血清学试验相对复杂,应当综合分析;要重视血液选择策略,避免出现输血反应。

Objective To analyze the Evan＇s syndrome patientsr serum tests results,and discuss the strategy for transfusion. Methods Patients＇ RBC was dealt with heat elution or chloroquine elution according to the direct an- tiglobulin test results. The RBC was divided equally for two parts after elution test,one was used to test the ABO and Rh group,and the other was used to absorpt with autoserum. Irregular antibody was screened and identified with elu- ant or the serum after absorption test. Homotype blood was chosen for cross match blood test in saline, polybrene and LISS/Coomb＇s card. Results All patients＇ blood was tested correctly. Antibody-like E was identified in tWO cases, antibody S was identified in one ease, and one patient＇s antibody specificity was not identified. Blood cross match blood test was negative. Conclusion Correct serum tests are complicated for Evan syndrome patient,and strategy for transfusion should be emphasized to avoid transfusion reaction.