凝集法在血型正反定型不符鉴定中的价值及不规则抗体阳性特异性结果分析

Value of agglutination method in the identification of positive and negative blood type inconsistency and the analysis of the positive and specific results of irregular antibodies

目的探讨凝集法在血型正反定型不符鉴定中的价值及不规则抗体阳性特异性结果分析。方法选择2018年4月至2020年5月萍乡市人民医院输血科181例进行输血治疗患者作为研究对象,采用凝集法完成血型正反定型和Rh定型分析,分析血型正反定型不符鉴定结果、原因,对不规则抗体阳性特异性结果进行分析。结果经正定型血清标本检测,其中红细胞为A型46例,血清抗体检出率为73.91%,正反定型不相符为15.22%;红细胞为B型78例,血清抗体检出率为67.95%,正反定型不相符为8.97%;红细胞为O型患者57例,血清抗体检出率为73.68%,正反定型不相符为7.02%;181例进行输血患者均采用凝集法完成血型正反定型分析,结果表明:18例患者正反型不符,占9.94%。ABO血型正反型不符原因中排在前2位的分别为造血干细胞移植和抗原减弱或发生缺失,分别占50.0%和27.78%;181例进行输血患者均完成Rh定型分析,结果表明:21例患者存在不规则抗体,占11.60%,男性患者与女性患者Rh定型分析中不规则抗体检出率比较,差异无统计意义(P>0.05)。结论凝集法用于血型正反定型与Rh定型中准确性较高,具有准确性、可靠性优点,能有效的节约试剂,提高血型定型的自动化水平,提高患者输血安全性。

Objective To explore the value of agglutination method in the identification of positive and negative blood type inconsistency and the analysis of the positive and specific results of irregular antibodies.Methods A total of 181 patients undergoing blood transfusion treatment in the Department of Blood Transfusion of Pingxiang People′s Hospital from April 2018 to May 2020 were selected as the research subjects.The agglutination method was used to complete the positive and negative blood type typing and Rh type analysis,and the identification results and reasons for the inconsistency of the positive and negative blood type typing were analyzed.The positive and specific results of irregular antibodies were analyzed.Results The positive-type serum samples were detected,among which 46 cases were red blood cells of type A,the detection rate of serum antibodies was 73.91%,and the difference between positive and negative typing was 15.22%.78 cases of red blood cells were type B,the detection rate of serum antibodies was 67.95%,and the positive rate was 67.95%.The inconsistency rate of reverse typing was 8.97%.57 patients with red blood cells were type O,the serum antibody detection rate was 73.68%,and the inconsistency between positive and negative typing was 7.02%.181 patients who received blood transfusion were all analyzed by agglutination method to complete positive and negative blood typing analysis.The results showed that the positive and negative types of 18 patients did not match,accounting for 9.94%.The top two causes of ABO blood type inconsistency were hematopoietic stem cell transplantation and antigen weakening or deletion,accounting for 50.0%and 27.78%,respectively.181 patients who underwent blood transfusion completed Rh typing analysis,and the results showed that 21 cases of patients had irregular antibodies,accounting for 11.60%.There was no significant difference in the detection rate of irregular antibodies in the Rh typing analysis between male patients and female patients(P>0.05).Conclusion Agglutination method has high accuracy in positive and negative blood typing and Rh typing,has the advantages of accuracy and reliability,can effectively save reagents,improve the automation level of blood typing and improve the safety of blood transfusion.