IgG型抗-Fy^b合并抗-H案例分析

IgG anti-Fyb antibody combined with anti-H antibody:a case analysis

目的通过一系列免疫血清学试验进行不规则抗体鉴定,查找引起血型正反定型不符的原因。方法用试管法做血型正反定型试验和不规则抗体筛查试验,用抗球蛋白法进行不规则抗体筛查、鉴定以及交叉配血试验、抗体吸收试验、热放散试验（56℃）等,以明确患者血清中存在的抗体种类和性质。结果患者血型为AB型,血清中检测出Ig G型抗-Fyb合并抗-H冷抗体,造成血型正反定型不符,与O型红细胞交叉配血不相合。结论血型检测时,反定型有必要加O型红细胞,输血前有必要进行不规则抗体筛查,以检测ABO血型系统以外的抗体。若结果阳性,应当明确抗体性质和种类,交叉配血时归避相应抗原,不可盲目输注O型红细胞,以保证临床输血安全。

Objective A series of immunoserological tests were performed to identify irregu Lar antibodies and to identify the causes of the inconsistent results in blood typing. Methods Blood typing tests were performed by the tube method. To identify the types and properties of irregular antibodies,anti-human-globulin tests were conducted for the identification of irregular antibodies. Extra cross matching tests,antibody absorption tests and heat release tests（ 56℃） were conducted as well to further confirm the antibody status of the patient. Results The blood type of the patient was AB. In his serum,Ig G antiFyb antibody combined with anti-H antibody was detected,which led to the unconformity of forward and reverse typing. His serum was incompatible with type O red blood cells. Conclusion Type O red blood cells is necessary in reverse typing tests.Irregular antibody tests is required before transfusion to identify any non-ABO type antibodies. With positive results,the antibodies detected need to be carefully confirmed and avoid such antibodies in cross matching. Transfusion of type O red blood cells may not be proceed inadequate pre-transfusion tests to ensure transfusion safety.