Lewis血型系统抗体的研究

Analysis of Lewis antigen system antibody

目的探讨Lewis血型系统抗体对于输血前检查的影响。方法对医院送检的抗体筛选阳性、交叉配血不合的血标本做抗体鉴定。ABO定型采用试管法;试管法盐水介质和Liss/Coombs卡做抗体鉴定和交叉配血;同时鉴定Lewis血型。结果确认84例标本均为Lewis血型抗体,Lewis血型均为Le(a-b-);其中抗-Lea阳性标本74例,抗-Leb阳性标本8例,抗-Lea+Leb阳性标本2例。抗体筛选和鉴定试验,仅在盐水介质中抗体阳性24例,仅在Liss/Coombs卡抗体阳性14例,试管法和Liss/Coombs卡抗体均阳性46例。10例标本试管法ABO血型鉴定中干扰血型反定型。结论产生Lewis血型抗体的个体血型均为Le(a-b-);Lewis血型抗体可与ABO反定型试剂红细胞发生反应干扰ABO血型定型;盐水介质和抗人球蛋白介质抗体筛选并举可避免Lewis血型系统抗体的漏检。

Objective To study the influence of antibody to Lewis antigen system on pre-transfusion test. Methods Eighty-four samples submitted by hospitals for positive antibody during screening and incompatible during cross-match test were carried out for antibody identification. ABO typing was detected by tube method, antidody identification and cross-matching was detected by tube saline method and Liss-Coombs card. Lewis antigens of the samples were detected. Results Lewis phenotypes of all 84 samples were Le^（a-b-）. Anti-Lea was detected in serum of 74 samples, anti-Leh was detected in 8 samples, anti-Lea＋ anti-Leh co-existed in serum of 2 samples. Antibody screening test was positive in all 84 samples, 24 samples were detected through tube saline method, 14 samples were detected through Liss-Coombs card, 46 samples were positive in both methods. Reverse typing of routine serological ABO group was disturbed in 10 samples. Conclusion The individual blood type produced by Lewis antigen system antibody are all Le^（a-b-）. Lewis antibody can cause ABO discrepancy. Combining tube saline with Liss-Coombs method can help to detect antibody against Lewis system.