多血型系统抗体鉴定和交叉配血策略一例抗-f合并抗-M

Multi-blood Group System Antibody Identification and Cross-matching Strategies:One Case of Anti-f Combined with Anti-M

目的鉴定一例患者血浆中抗体的特异性并制定交叉配血的策略。方法采用盐水介质试管法和抗人球蛋白卡(LISS/Coombs卡)做抗体筛选和抗体鉴定,根据谱细胞、酶处理谱细胞及4℃谱细胞反应格局,确定患者血浆中意外抗体的特异性。结果患者Rh血型为CCDee,MN血型为NN。多种抗体鉴定结果显示,其血浆中存在同种抗体:Rh血型系统抗-f(f:ce复合抗原)合并MNS血型系统抗-M。结论抗-f仅与具有f抗原(R0、r)的红细胞反应,且能被蛋白水解酶增强;IgG类抗-M在4℃环境的反应性更强。经过输血免疫后,患者产生抗-f和抗-M抗体,交叉配血策略为优先选择无M抗原红细胞进行交叉配血,对配血相合的红细胞成分血进行RhCE抗原检测,选择无f抗原红细胞发血。

Objective To identify the specificity of antibodies in plasma of patients and develop strategies for cross matching.Methods Antibodies were screened and identified by saline medium test tube method and LISS/Coombs card,and the specificity of plasma antibodies was determined by the reaction patterns of the Makropanel 16,the Makropanel 16-P and the panel cell at 4℃.Results The patient's Rh blood group was CCDee and MN blood group was NN.Multiple antibody identification results showed that there were alloantibodies in the plasma:anti-f(f:ce composite antigen)of Rh blood group system and anti-M of MNS blood group system.Conclusion Anti-f only reacted with red blood cells containing f antigen(R0,r)and can be enhanced by proteolytic enzymes.The IgG anti-M showed stronger reactivity in the 4℃environment.After the transfusion and immunization,the patient produced anti-f and anti-M antibodies.In clinical blood matching,red blood cells without M antigen were preferentially selected for cross matching,RhCE antigen was detected according to blood matching results,and red blood cells without f antigen were selected for transfusion.