IgM自身抗体干扰同种抗体鉴定的处理对策

Treatment strategies of IgM autoantibodies interfering with identification of alloantibodies

目的 :探讨IgM自身抗体致同种抗体鉴定困难的处理对策。方法 :通过血型反定型异常筛选9例IgM自身抗体干扰同种抗体鉴定的标本,进行兔红细胞基质、自体/异体红细胞吸附法后再行同种抗体筛查、鉴定。结果 :存在IgM自身抗体干扰的9例标本中,有2例检出合并同种抗体,其特异性分别为IgG抗-E和IgM抗-Lea。结论 :IgM自身抗体干扰同种抗体鉴定时,可根据其效价的高低和输血史的有无选择不同吸附法排除其干扰,准确鉴定同种抗体特异性,并选择抗原匹配的血液输注,确保输血疗效和安全。

Objective To explore countermeasures for difficulties in identifying alloantibodies caused by IgM autoantibodies. Methods Nine samples with difficulties in identification of alloantibodies caused by interference of IgM autoantibodies were acquired by abnormal reverse blood typing results. Then these samples were used for screening and identifying alloantibodies after rabbit erythrocyte matrix and autogenous/allogeneic erythrocyte adsorption were conducted. Results Of the nine specimens in which IgM autoantibodies interfered, two samples had autoantibodies combined with IgG anti-E and IgM anti-Lea, respectively. Conclusions When IgM autoantibodies interfere with the identification of alloantibodies, different adsorption methods can be selected according to the level of its titer and the history of blood transfusion to eliminate the interference, accurately identify the specificity of alloantibodies, and select the matching blood product for ensuring the efficacy and safety of blood transfusion.