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高效价抗-M抗体急诊输血的策略探讨——附1例交叉配血不合病例报告 被引量:4

Emergency transfusion strategy of patient with high titer anti-M antibody:a case report
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摘要 目的报告1例高效价抗-M抗体引起的交叉配血不合患者,探讨高效价抗-M抗体对交叉配血的影响及其在急诊输血流程中的处置策略。方法复旦大学附属中山医院厦门医院于2022年2月7日收治1例交叉配血不合的急诊手术患者,检测ABO血型、Rh血型和MN血型,进行不规则抗体筛查与鉴定、抗体效价和交叉配血试验。结果患者为54岁男性,因“突发胸背痛3 d”入院,诊断为主动脉弓动脉瘤先兆破裂,需行急诊手术。患者血型鉴定结果为O、CcDee、NN型,不规则抗体筛查试验结果阳性;检测抗体特异性,发现患者体内存在高效价抗-M抗体,免疫球蛋白M(IgM)型抗-M抗体效价为1︰1024,且在37℃条件下有活性,干扰交叉配血。患者术中输注O、CcDee、NN型去白细胞悬浮红细胞2 U,输注有效且无输血不良反应。结论急诊患者输血前有必要进行不规则抗体筛查并鉴定抗体特异性,进而在配血时规避对应的抗原,避免发生溶血性输血反应。对该病例的治疗探讨了对抗-M抗体患者在急诊输血流程中的处置策略,确保急诊患者输血安全。 Objective To report a case of cross matching incompatibility caused by high titer anti-M antibody and to explore the influence of high titer anti-M antibody on cross matching and its treatment strategy in the emergency blood transfusion process.Methods A case of incompatibility with cross matching blood in emergency operation was admitted in Zhongshan Hospital,Fudan University(Xiamen Branch)on February 7,2022.ABO,Rh and MN blood type identification tests,irregular antibody screening test,antibody identification,antibody titer test and cross matching test were performed.Results The patient,a 54-year-old male,was hospitalized due to"sudden chest and back pain for 3 days".He was diagnosed as threatened rupture of aortic arch aneurysm and needed emergency surgery.The results of blood type identification were O,CcDee,NN type and positive for irregular antibody screening test.After the specific identification of antibody,there was a high titer anti-M antibody in the patient's plasma.The titer of IgM anti-M antibody was 1︰1024 and it was active at 37℃,which interfered with cross matching.Intraoperative infusion of 2 U leucocyte suspension erythrocyte with O,CcDee and N type was effective and no adverse blood transfusion reactions were observed.Conclusions It is necessary to conduct irregular antibodies screening and identify their specificity before transfusion in emergency patients,so as to avoid the corresponding antigens for blood matching and avoid hemolytic blood transfusion reaction.The treatment strategy of anti-M antibody patients in emergency blood transfusion process was discussed in the treatment of this case to ensure the safety of emergency blood transfusion.
作者 王翠碧 陈玮媛 熊磊群 张萍萍 雷棽 吕小英 Wang Cuibi;Chen Weiyuan;Xiong Leiqun;Zhang Pingping;Lei Shen;Lyu Xiaoying(Department of Blood Transfusion,Zhongshan Hospital,Fudan University(Xiamen Branch),Xiamen 361015,Fujian,China)
出处 《实用检验医师杂志》 2022年第2期208-211,共4页 Chinese Journal of Clinical Pathologist
基金 复旦大学附属中山医院厦门医院孵化课题(2020ZSXMYJ02)。
关键词 抗-M抗体 MNS血型 交叉配血 急诊输血 Anti-M antibody MNS blood type Blood cross matching Emergency blood transfusion
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  • 1向东,刘曦,王健莲,张嘉敏,张雄民.患者血型不规则抗体的分析[J].中国输血杂志,2005,18(1):22-23. 被引量:55
  • 2陈民才,王全立.O型全血及红细胞异型输注回顾与展望[J].第三军医大学学报,2005,27(8):804-805. 被引量:5
  • 3吴远军,刘彦慧,刘兴玲,刘景春,吴勇,陈宝婵,梁燕.汉族患者(30800例)及孕妇(4200例)红细胞血型不规则抗体分布的调查[J].第四军医大学学报,2007,28(10):922-925. 被引量:57
  • 4Urbaniak SJ. The scientific basis of antenatal prophylaxis [J]. Br J Obstet Gynaecol, 1998, 105 (Suppl 18): 11-18.
  • 5Flegel WA, Wagner FF, Mailer TH, et al. Rh phenotype prediction by DNA typing and its application to practice [J]. Transfus Med, 1998, 8 (4): 281-302.
  • 6Schwab CW,Civil I, Shayne JP. Salineexpanded group O uncrossmatched packed red blood cells as an initial resuscitation fluid in severe shock[J]. Ann Emerg Med, 1986, 15 (11) : 1282- 1287.
  • 7Milner LV, Butcher K. Transfusion reactions reported after transfusions of red blood cells and of whole blood[J]. Transfusion, 1978,18(4) : 493-495.
  • 8Dzik WH. Apoptosis, TGF beta and transfusion-related immunosuppression:biologic versus clinical effects [J]. Transfus Apher Sci, 2003,29 (2) 127-129.
  • 9中华人民共和国卫生部.临床输血技术规范.[2000]卫医发字第184号.
  • 10AABB. Technical manual. 16 th ed. Betheda: AABB. 2008:504- 510.

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