鉴定抗-Le^b抗体对输血结果的影响:附1例漏检病例分析

Effect of identification of anti-Le^b antibody on blood transfusion results: analysis of a case of missed examination

目的通过1例鉴定抗-Le^b抗体的过程,评估Lewis血型系统抗体特点和临床意义。方法采用微柱凝集卡和盐水试管法进行血型鉴定,采用卡式抗人球方法和盐水介质试管法进行抗体筛查、抗体鉴定和交叉配血。根据患者的血红蛋白(Hb)、总胆红素(TBil)、直接胆红素(DBil)、乳酸脱氢酶(LDH)检测结果评估输血效果。结果患者血型为B型,血清检出抗-Le^b抗体,Lewis血型系统表型为Le^a-b-。结论对于体内存在抗-Leb的受血者,建议选择无对应抗原,且抗人球蛋白法和盐水法配血相合的供者红细胞进行输血,以提高输血安全性。

Objective Through a case course of identification of anti-Le^b antibody to evaluate the antibody characteristics and clinical significance of Lewis blood group system. Methods The blood group identification was performed by micro-column lecturing card and brine test tube method, and antibody screening,antibody identification and cross matching were carried out by clamping anti-human ball method and brine medium test tube method. The blood transfusion effect was evaluated by the patient’s results of blood hemoglobin(Hb),total bilirubin(TBil), direct bilirubin(DBil) and lactate dehydrogenase(LDH). Results The blood group of the patient was type B, anti-Le^b antibody was detected in the serum, and the phenotype of Lewis blood group system was Le^a-b-. Conclusion It is suggested that the recipients with anti-Le^b in vivo could only use the donor red blood cells(RBCs) without corresponding antigen and matching with donor RBCs in the antihuman globulin and saline testing methods for blood transfusion in order to improve the safety of the transfusion.