补体C_3d对抗人球蛋白交叉配血的影响及处理分析

Effect of complement C_3d on antihuman globulin crossmatch and its management

目的:分析临床患者交叉配血试验中使用不同抗人球蛋白试剂结果不一致的因素,为临床出现抗人球蛋白法疑难配血提供借鉴及处理对策。方法:采用广谱及单特异性抗人球蛋白检测卡对患者进行血清学检测,并应用不同抗人球蛋白试剂进行试管法复查,其中交叉配血试验将患者血清56℃30min处理后再进行卡式法及试管法验证。结果:2例患者样本均为使用单特异性抗-IgG试剂配血相合,使用广谱及抗-C_3d试剂配血不合。且患者血清经56℃30min处理后使用不同试剂均配血相合。结论:结合患者临床病例资料,证实2例样本均是由血清中补体C_3d成分对使用广谱试剂的抗人球蛋白配血试验造成干扰,可给予单特异性抗-IgG试剂下配血相合血液输注,以改善其贫血症状。

Objective：To analyze the factors that result in inconsistent results in clinical patients＇ blood crossmatching test using different anti-human globulin reagents,and provide reference and countermeasure for the clinical emergence of difficulty in blood cross-matching test in anti-human globulin method.Method：The patients were serologically tested with broad-spectrum and monospecific anti-human globulin test cards,and the serum of the patients which were inconsistent in blood cross-matched test was treated at 56℃ for 30 minutes,and then verification tests were performed using different anti-human globulin reagents.Result：Two patients were consistent with monospecific anti-IgG reagent but inconsistent with broad-spectrum or anti-C3d reagent in blood cross-matched test,and both patients were consistent with different reagents after the serum was treated at 56℃ for 30 minutes.Conclusion：Combined with the clinical data of both patients,it was confirmed that the two samples which were inconsistent in blood cross-matching test were caused by the complement C3d components in the serum which might cause interference in blood cross-matching test using broad-spectrum anti-human globulin reagent,and the blood which was consistent in blood cross-matching test with monospecific anti-IgG reagent could be used for blood transfusion to improve the anemia symptoms of the patients.