高效价抗-M抗体对血型鉴定的影响及解决策略

The effect of high-potency anti-M antibody on blood group identification and its solution

目的:研究抗-M抗体对血型鉴定及交叉配血的影响。方法:采用血型血清学方法进行ABO血型、RhD血型及MN血型鉴定试验,直接抗人球蛋白试验,不规则抗体筛查试验,抗体效价测定试验,吸收放散试验及交叉配血等试验。结果:2例患者均出现正反定型不一致的现象且不规则抗体检测阳性,反应格局相同;进一步检测发现患者体内均存在高效价抗-M抗体,且在37℃有活性,干扰血型鉴定和交叉配血。采用吸收试验可有效消除抗-M抗体的干扰,选择与患者同型且M抗原阴性的供血者配血均相合。结论:ABO血型鉴定出现正反定型不一致时,有必要进行抗体筛查及鉴定,以发现具有临床意义的不规则抗体,进而选择对应抗原阴性的供血者进行配血,保障临床患者输血安全。

Objective: To study the effect of anti-M antibody on blood type identification and cross matching. Methods: ABO blood group, RhD blood group and MN blood group identification test, direct anti-human globulin test, irregular antibody screening test, antibody titer test, absorption and release test and cross matching tests were carried out by blood group serological method. Results: Both patients showed inconsistent positive and negative stereotyping and positive irregular antibody detection, with the same reaction pattern. Further tests showed that there were high titeranti-M antibodies in all patients and were active at 37℃, which interfered with blood group identification and cross matching. The interference of anti-M antibody can be effectively eliminated by absorption test, and the blood matching of donors with the same type and negative M antigen can be selected. Conclusion: When the ABO blood group is inconsistent with positive and negative stereotypes, it is necessary to conduct antibody screening and identification to find irregular antibodies of clinical significance, and then select the donor with negative corresponding antigen for blood matching, so as to ensure the blood transfusion safety of clinical patients.