沧州地区患者ABO血型正反定型不符调查研究

Investigation of ABO blood group typing inconsistent in Cangzhou area

目的:分析沧州地区患者ABO正反定型不符原因,采取应对措施,保证输血安全。方法:收集2005-2012年临床送检患者ABO正反定型不符标本及临床资料,应用ABO血型正反定型、吸收放散、血型物质检测、抗体鉴定等血型血清学方法,对疑为ABO亚型的有条件者收集其家系资料,做分子生物学鉴定。结果:114例血型正反定型不符原因依次为冷凝集素30例(26.3%),抗体减弱23例(20.2%),血浆异常14例(12.3%),人为因素12例(10.5%),自身抗体10例(8.8%),ABO亚型8例(7%),不规则抗体6例(5.3%),抗原减弱5例(4.4%),输异型血4例(3.5%),溶血2例(1.8%);2005-2012年临床送检不符标本量及冷凝集素、抗体减弱、人为因素等送检原因呈下降趋势。结论:患者ABO正反定型不符时,应结合患者的年龄、临床诊断、近期输血史、输液史等临床资料,加做血型血清学试验,有条件者辅助分子生物学试验,正确鉴定ABO血型,有效防止亚型及有意义不规则抗体的漏检,确保临床输血安全;加强对临床输血的督导和医护人员输血知识的培训有效减少了患者ABO正反定型不符的送检量。

Objective：To analyze the reason of ABO blood group typing inconsistent in Cangzhou area and take measures to ensure the safety of blood transfusion. Method：Speci- mens and clinical data of patients with ABO blood group typing inconsistent from 2005 to 2012 were collected and detected by using serological methods such as ABO blood group typing,absorption and elution, blood group substance detection and antibody identification. For suspected ABO subtype patients whose conditions were permitted,their pedigree data were collected and molecular biological identification done. Result：The causes of 114 cases of blood group typing discrepancy were cold agglutinin of 30 ca- ses （26.3%）,antibodies reduced 23 cases （20.2%）,abnormal plasma 14 cases （12.3%）,human factors 12 cases （10. 5%）, autoimmune antibodies 10 cases （8. 8%）, ABO subtypes 8 cases （7%）, irregular antibody 6 case （5.3 % ）, antigen weakened 5 cases （4.4 % ）, abnormal blood transfusion 4 cases （3.50% ）, and hemolysis 2 cases （1.8 % ）. The specimen number of clinical inspection disqualification, cold agglutinin, antibody decreased and human factors decreased in 2005--2012 years. Conclusion：Patients with ABO blood group typing inconsistent should be combined judged with clinical data such as the age of the patients, clinical diagnosis, the recent history of blood transfusion and transfusiott history, and took serological test and molecular biology test if conditions permitting. Correct identification of ABO blood group could effectively prevent missing detection of subtype and significant ir- regular antibody,and ensure the safety of clinical blood transfusion. Strengthening the supervision of clinical blood transfusion and blood transfusion knowledge training of medical personnel could effectively reduce the clinical in- spection disqualification specimen number with ABO blood group typing inconsistent.