120例ABO血型正反定型不符影响因素分析及对策浅析

Analysis on the influencing factors of ABO typing discrepancy in 120 cases and potential counter strategies

目的分析ABO血型正反定型不符的常见影响因素,探讨其处理对策,提高解决疑难ABO血型定型的能力。方法回顾性分析本院2013—2016年采用微柱凝胶法鉴定的血型标本141 679例,对ABO血型正反定型不符的标本,结合具体病史采用针对性的实验。结果共检出ABO血型正反定型不符标本120例,在影响血型正反不符的因素中,人为因素占10%（12/120）,生理因素占16.7%（20/120）,疾病因素占54.2%（65/120）,治疗因素占16.7%（20/120）,其它因素占2.5%（3/120）。在所有引起的ABO血型正反不符因素中,恶性血液病占41.2%（50/120）,骨髓移植占16.7%（20/120）,标本干扰占13.3%（16/120）,自身抗体占12.5%（15/120）,其它因素占15.8%（19/120）。结论引起ABO血型正反定型不符的原因主要是：疾病因素（主要是恶性血液病）、治疗因素（主要是骨髓移植）、标本干扰（标本稀释、溶血、脂血、纤维蛋白原）等,须结合具体病史及其他针对性实验确定ABO血型,保证临床输血安全。

Objective To analyze the influencing factors causing ABO typing discrepancy and propose potential counter measures improving the overall performance of ABO blood group typing. Methods We retrospectively analyzed 141679 ABO blood group typing cases filed during 2013—2016 with microcolumn gel technique in our hospital. For those cases with ABO typing discrepancy,according to patients＇ medical history,pertinent methods were used to determine the ABO blood group.Results We found 120 cases of ABO typing discrepancies during these four years,among these factors influencing ABO typing discrepancies,artificial factors accounted for 10%（12/120）, physiology factors accounted for 16. 7%（20/120）,disease factors accounted for 54. 2%（65/120）,treatment factors accounted for 16. 7%（20/120） and others accounted for2. 5%（3/120）. Of all the factors,malignancy hematologic disease accounted for 41. 2%（50/120）,bone marrow transplantation accounted for 16. 7%（20/120）,specimens interference accounted for 13. 3%（16/120）,autoantibodies accounted for 12. 5%（15/120） and others accounted for 15. 8%（19/120）. Conclusion In this study,ABO typing discrepancies were mainly caused by disease factors（mainly malignancy hematologic disease）,treatment factors（mainly bone marrow transplantation）,specimens interference factors（including hemolysis,fat,fibrinogen,or dilution）. To ensure the safety of clinical blood transfusion,combining disease history with other pertinent experiments to determine ABO blood group is necessary.