补体调节缺陷对ABO血型不合输血引起溶血反应的潜在影响研究

Potential effect of complement regulation defect on hemolytic reaction induced by ABO blood type incompatibility transfusion

目的:探讨补体调节缺陷对ABO血型不合输血引起溶血反应的潜在影响。方法:选取60例O型献血者血液标本作为研究对象,分别分离A1红细胞和抗A抗体,分析所有标本的抗A效价及补体激活情况,比较不同红细胞组补体激活和溶血情况。结果:流式细胞术检测结果显示经AET处理后的红细胞表面缺失MIRL,所有60例献血者血清IgM效价均<100,8例IgG效价<100,52例IgG效价>100,其中有20例C3b补体激活,Sperman相关性分析结果显示IgM抗A效价与补体激活显著正相关(r=0.727,P<0.01),未处理组红细胞未观察到溶血,而经AET处理组红细胞观察到溶血,20%AET处理组红细胞可见轻微溶血。结论:反应性溶血膜抑制物缺陷可能是ABO血型不合输血引起溶血反应的影响因素。

Objective:To investigate the potential effect of complement regulation defect on hemolytic reaction induced by transfusion of ABO blood group incompatibility.Method:Sixty blood samples of O type blood donors were selected as study objects,A1 erythrocytes and anti A antibodies were isolated respectively.The anti-A titers and complement activation of all specimens were analyzed.Result:Flow cytometry showed that the surface of RBC was absent after AET treatment.The IgM titer of all 60 donors was less than 100,8 cases IgG titer>100,and 52 cases IgG titer>100,and C3 b complement of 20 cases were activated.Sperman correlation analysis showed that there was a significant positive correlation between the titer of anti-A of IgM and the activation of complement(P<0.01).The hemolysis was not observed in the untreated group,but hemolysis was observed in the AET treated group,and slight hemolysis in the 20% AET treatment group.Conclusion:The defect of reactive hemolytic membrane inhibitor may be the influencing factor of hemolytic reaction caused by transfusion of ABO blood type incompatibility.