57例多发性骨髓瘤引起ABO血型鉴定异常的原因及对策

Reasons and countermeasures in 57 cases of abnormal ABO blood group identification induced by multiple myeloma

目的分析57例多发性骨髓瘤引起ABO血型鉴定异常的各种原因及解决策略。方法随机用美国ORTHO Auto Vue Innova、美国BIO-RAD IH1000、西班牙GRIFOLS ERYTRA全自动血型仪检测出多发性骨髓瘤引起的ABO血型鉴定异常标本共57例。采用血型鉴定试管法、吸收放散实验、抗体鉴定等多种方法辅助进行ABO血型判断。结果多发性骨髓瘤引起的ABO血型鉴定异常的57例中,抗体减弱引起25例(43.9%);冷抗体干扰引起12例(21.1%);蛋白凝集干扰引起10例(17.4%);抗体丢失引起5例(8.8%);抗原与抗体变异引起3例(5.3%);抗原减弱引起2例(3.5%)。结论多发性骨髓瘤引起ABO血型鉴定异常的主要原因是患者抗体减弱,其次是冷抗体干扰、蛋白凝集干扰、抗体丢失、抗原与抗体变异、抗原减弱等。可以根据多发性骨髓瘤引起ABO血型异常的实验结果及患者病史选择相应的辅助实验进行正确的血型鉴定,保障患者临床输血安全。

Objective To analyze 57 cases of abnormal ABO blood group identification caused by multiple myeloma and to find a resolution strategy. Methods The ORTHO AutoVue Innova, the BIO-RAD IH1000 and Spain GRIFOLS ERYTRA automatic instrument were randomly used to detect the abnormal blood specimens caused by multiple myeloma in a total of 57 cases. Blood typing test tube method, absorption radiation experiment and antibody identification were used to identify ABO blood groups. Results Among the 57 cases with abnormal ABO blood groups caused by multiple myeloma, weakened antibodies accounted for 25 cases （43.9%）, cold antibody interference accounted for 12 cases （21.1% ）, protein aggregation interference accounted for 10 cases （ 17.4% ）, antibody disappearance accounted for 5 patients （ 8.8% ）, antigen and antibody mutation accounted for 3 patients （5.3%）, weakened antigen accounted for 2 cases （3.5%）. Conclusion Abnormal ABO blood group identification caused by multiple myeloma constitutes the main reason for the reduction in antibodies in patients, followed by cold antibody interference, protein aggregation, antibody disappearance, mutation in antigen and antibod- y, weakened antigen, etc. Experimental results obtained from the abnormal ABO blood group identification could determine corresponding experiment in order to identify the correct blood type and to ensure the safety of clinical blood transfusion.