MNS意外抗体检测及对血型鉴定和交叉配血影响的研究

The effect of accidental MNS antibodies on blood type identification and cross matching

目的:研究MNS抗体特性,并探索如何有效减少其对血型鉴定和交叉配血的干扰。方法:选取2015-01—2017-12血型正反定型不符和交叉配血不合的标本427例进行意外抗体筛查、鉴定,检测MNS抗体性质,自备反定型标准红细胞(RBC),对交叉不合标本重新鉴定血型,46例阳性患者予以不含相应抗原的RBC重新交叉,比较输血前后Hb、RBC、Hct差异情况。结果:427例标本中MNS抗体阳性105例,其中抗-M抗体93例,抗-N抗体4例,抗-S抗体6例,抗Mur抗体2例。女性MNS抗体中IgM类66例,IgG类9例,IgM+IgG类6例,女性有输血和妊娠史37例(45.68%),单独妊娠史22例(27.16%),用不含相应抗原的ABO同型血重新鉴定血型,结果正反定型相符。46例患者共输注缺少相应抗原RBC 96单位,输血前后Hb、RBC、Hct差异均有统计学意义(t=60.575,45.299,80.426,均P=0.000)。结论:MNS意外抗体大部分为抗-M,抗体性质以IgM为主,当遇血型正反不符、交叉不合时应采用多种方法进行检测,以正确判断血型并进行交叉配血,确保临床输血安全。

Objective：To study the characteristics of MNS antibody and explore how to effectively reduce its interference with blood group identification and cross-matching.Method：Accidental antibody screening and identification were perfor med on 427 blood cases（from January 2015 to December 2017）of inconsistent positive and negative stereotypes and cross-incompatible ones,in order to test the nature of MNS antibody.After preparing anti-type RBC,blood samples were re-identified on positive specimens.Cross-incompatible specimens were given RBCs without corresponding antigens and cross again.Result：Of the 427 specimens,105 were positive for MNS antibodies,93 for anti-M antibodies,4 for anti-N antibodies,6 for anti-S antibodies,2 for anti-Mur antibodies,66 for IgM antibodies in female patients,9 for IgG antibodies and 6 for IgM＋IgG antibodies.There were 37 cases had blood transfusion and pregnancy history,accounting for 45.68%,and 22 cases had pregnancy history alone,accounting for27.16%.After the blood group was re-identified and cross-matched,the results showed that positive and negative stereotypes were consistent and cross-compatible.There was a lack of corresponding antigen RBC 96 unit in 46 patients.There were significant differences in Hb,RBC and Hct before and after blood transfusion（t=60.575,45.299,80.426,P=0.000）.Conclusion：The MNS accidental antibody is mainly anti-M,antibody properties are mainly IgM.To deal with inconsistent positive and negative or cross-incompatible blood specimens,multiple methods should be used to detect blood types and cross matching to ensure the safety of clinical transfusion.