3种筛选红细胞在疑难配血筛检致敏不规则抗体中的应用比较

Application comparison of three kinds of screened red blood cells in screening sensitized irregular antibodies in difficult matching blood

目的探讨3种筛选红细胞(配组红细胞、混合O型红细胞和抗体筛选红细胞)对致敏红细胞不规则抗体的筛检效果。方法对36例临床交叉配血申请进行聚凝胺法、生理盐水法与微柱凝胶法交叉配血试验,不合者拟做微柱凝集法Coomb’s试验筛查原因,受、供血者直接Coomb’s试验阳性的排除补体致敏后进行致敏红细胞放散试验,并以3种筛选红细胞筛检放散液中可能存在的不规则抗体。结果1例主侧、次侧均不合者,受血者直接Coomb’s试验(生理盐水介质法)筛检阳性、间接Coomb’s试验筛检阳性,供血者直接、间接Coomb’s试验筛检阴性;受血者致敏红细胞放散试验,3种筛选红细胞筛检放散液不规则抗体均为阳性。结论对交叉配血试验不合者进行原因筛查时,抗体筛选红细胞可用于游离/致敏不规则抗体的筛检。

Objective To explore the screening effect of three kinds of screened red blood cells(matched red blood cells,mixed O-type red blood cells and antibody screened red blood cells)on irregular antibodies of sensitized red blood cells.Methods Thirty six cases of clinical cross matching application were carried out by cross matching test of polybrene method,normal saline method and microcolumn gel method.Reasons for screening incompatible cases were investigated by Coomb's test with microcolumn agglutination method.Sensitized erythrocyte diffusion test was performed with positive for direct Coomb's test in recipients and donors after eliminating complements sensitization.Irregular antibodies in the release solution were screened by three kinds of screened red blood cells.Results Direct Coomb's test(normal saline medium method)and indirect Coomb's test for screening were positive of the recipient and negative of the donor in one case with incompatibility of the main side and the secondary side.After eliminating complement sensitization,the sensitized red blood cells diffusion test of the recipient were done,in which release solution irregular antibodies were all positive with the three screening erythrocyte methods.Conclu-sion When screening the causes of incompatibility in cross matching test,antibody screening red blood cells can be used for screening free or/and sensitized irregular antibodies.