剂量效应对输血相容性检测影响研究

Study of effect of dose effect on blood transfusion compatibility

目的:分析剂量效应对输血相容性检测的风险,对低效价抗体输血风险进行预警。方法:选取本院383例明确抗体特异性标本,通过回顾性分析研究抗体与不同抗原试剂红细胞组在不同方法中的反应格局、凝集强度和效价关系,以探讨剂量效应在输血相容性检测中的作用,并评估增强检测的方法。结果:剂量效应在盐水介质、抗人球介质中均有体现。抗M漏检杂合子比率最高,达19%,抗E为7.1%,抗JKa、抗JKb为3.7%。效价越低,不与杂合子抗原凝集的比例越大。使用PEG等方法有助于改善漏检情况。结论:特异性抗体会因剂量效应对杂合子抗原反应性降低。抗体效价较低时,进行交叉配血盲配存在假阴性风险,可采用PEG加强凝集的方法避免杂合子抗原漏检,或通过准确的抗体鉴定,匹配合适的供者血液。

Objective:To provide early warning for transfusion with low titer antibody by analyzing risks of dose effect on blood transfusion compatibility.Methods:383 antibody-specific samples were selected from our hospital,and relationship between antibody and different cells of panel including mode of reaction,agglutination intensity and titer was studied by retrospective analysis in order to explore the role of dose effect in blood transfusion compatibility detection and evaluate the methods of enhancement reactions.Results:Dose effect was found both in saline medium and anti-human globulin medium.The missing heterozygote ratio of anti-M was the highest reaching 19%,followed by anti-E,anti-JKa and anti-JKb with 7.1%,3.7%and 3.7%respectively.The lower the titer,the greater the proportion of non-agglutination with heterozygous antigen.In addition,the use of PEG can reduce the error of missed detection.Con⁃clusion:Specific antigen-antibody responses with heterozygous antigen are reduced due to dose effect.The false negative risk of blind cross-matching is increased by low-titer irregular antibodies.Enhanced reaction by PEG can be used to reduce missing detection rate of single dose antigen and providing matched blood after accurate antibody identification is another way.