抗-M抗体对血型鉴定及临床输血的影响

Influence of anti-M antibody on blood group identification and clinical transfusion

目的观察抗-M抗体对血型鉴定及临床输血的影响。方法8500例首次血型鉴定患者,通过微柱凝胶实验进行血型分析,采用抗人球蛋白实验(AT)对其进行抗体鉴定,采用放散实验、吸收实验消除不规则抗体的影响,使用交叉配血实验分析标本交叉配血结果,测定抗-M抗体效价。结果血型鉴定时借助微柱凝胶法、全自动血型仪,结果显示8500份标本中,正反定型相符8432份,正反定型不符68份。其中18份正反定型不符典型标本,经开展反定型试管法结果可见,A、B、O细胞管均呈阳性,而对照管结果呈阴性。去除标本中的2、3、6、8、9、11、12、13、15、17、18号,剩余7份抗-M抗体标本的患者行备血申请,分别与相应血型的供血者开展配血试验,利用盐水法,筛出阴性供血者,在借助凝聚胺配血试验,无凝集者提示配血成功。有3例患者进行交叉配血实验,接受了血液成分输注,如悬浮红细胞等,未见输血不良反应。评价疗效显示输注有效。结论明确因抗-M类不规则抗体所致交叉配血不合或反定型不符的标本,经2-巯基乙醇处理、吸收试验,可将其干扰消除,取得实验正确结果,并且在4℃温度下,可使抗-M类盐水抗体冷反应性检测率提高。

Objective To observe the influence of anti-M antibody on blood group identification and clinical transfusion.Methods 8500 patients with first-time blood typing were analyzed by microcolumn gel test,and their antibodies were identified by anti-globulin test(AT).The influence of irregular antibodies was eliminated by dispersion test and absorption test,and the results of cross matching of blood specimens were analyzed by cross-matching blood test to determine the titer of anti-M antibodies.Results Blood typing was done with the help of microcolumn gel method and automatic blood typing instrument,the results showed that out of 8500 specimens,8432 specimens were compatible with positive and reverse blood typing and 68 specimens were not compatible with positive and reverse blood typing.Among them,18 typical specimens with mismatched positive and reverse blood typing were found to have positive results in A,B,and O cell tubes through reverse typing test tube method,while the results of the control tube were negative.The specimens of 2,3,6,8,9,11,12,13,15,17,18 were removed,and blood preparation was applied for patients with the remaining 7 anti-M antibody specimens.Blood matching test was carried out on blood donors of corresponding blood types,and negative blood donors were screened by saline method,then with the help of coagulant amine blood matching test,the absence of agglutination suggested that the blood matching was successful.3 patients underwent cross-matching blood tests and received transfusions of blood components,such as suspended red blood cells,and no adverse reactions were observed.Evaluation showed that infusion was effective.Conclusion Specimens with cross matching incompatibility or reverse typing inconformity due to irregular anti-M antibodies can be processed with 2-mercaptoethanol and absorption test to eliminate their interference and obtain correct results,and the detection rate of the cold reactivity of anti-M saline antibodies can be increased at 4℃.