ABO疑难血型的鉴定分析思路和所需试剂应用

Identification and analysis of ABO difficult blood type and application of reagent needed

目的探讨基层医院ABO疑难血型鉴定的分析思路及所需试剂的应用。方法在本院输血科及宝鸡周边县区输血科2013年1月至2017年12月104例疑难血型鉴定标本中应用血清学实验。ABO疑难血型鉴定使用试管法,弱抗原、弱抗体及抗体筛选使用微柱凝胶法,依据试管反应的血清学特点。结合患者年龄、病例资料、遗传史等综合因素假设原因,设计针对性试验加以验证,最后确认血型。结果新生儿抗体减弱28例、老年人抗体减弱13例、冷凝集22例、不规则抗体16例、蛋白凝集11例、亚型9例、抗原减弱5例。结论基层医院疑难血型主要原因是新生儿、老年人生理因素导致抗体减弱、冷凝集、不规则抗体、蛋白凝集,其次是亚型、抗原减弱等。熟练应用血清学方法可以解决常见的ABO疑难血型鉴定,保证临床用血安全及时有效。

Objective To explore the analysis ideas of ABO difficult blood type identification in primary hospitals and the application of necessary reagents.Methods Serological test method was used in 104 difficult blood type specimens from the blood transfusion department of our hospital and the neighboring district and county from January 2013 to December2017. The tube method was applied to ABO difficult blood type identification, the microcolumn gel test method was applied to weak antigen, weak antibody and antibody screening. According to the serological characteristics of test tube reaction,considering the causes of integrated assumptions such as the age of patients, medical record data and genetic history, we designed a targeted test method to clarify and determine the blood type.Results Twenty-eight cases of neonatal antibody were weakened, 13 cases of senile antibody were weakened, 22 cases were condensed set, 16 cases were irregular antibody, 11 cases were protein agglutination, 9 cases were subtype and 5 cases were antigen weakening.Conclusion The main reason of difficult blood type in primary hospitals is that the physiological factors of neonatal and elderly lead to antibody weaken, cold agglutination, irregular antibody and protein agglutination, followed by antigen weakening, etc. The skilful application of serological method can solve the common problems of ABO blood type identification, and ensure clinical blood safety in a timely manner.