多发性骨髓瘤患者白蛋白和球蛋白比值对红细胞凝聚及输注的影响

Effect of A/G ratio on erythrocyte aggregation and blood transfusion in patients with multiple myeloma

目的:研究多发性骨髓瘤患者血浆白蛋白和球蛋白的比值与非特异性凝聚的关联性以及对输血效果的影响。方法:收集41例多发性骨髓瘤患者的血样本,盐水介质法进行抗体筛选试验,观察是否出现非特异性凝聚,并检测患者白蛋白和球蛋白含量,计算比值,并评估输血后每单位Hb升高值;采用t检验进行统计学分析。结果:27例患者在盐水介质法抗体筛选中出现非特异性的凝聚,14例患者在盐水介质法抗体筛选中未出现特异性凝聚,所有样本抗体筛查均未检出IgM型不规则抗体。出现非特异性凝聚的患者白蛋白和球蛋白比值低于未出现非特异性凝聚的患者(t=-6.457,P<0.001);但在输血后每单位Hb升高值差异无统计学意义。结论:多发性骨髓瘤患者血浆白/球比值低于0.70后会在盐水介质中出现非特异性的凝聚,但不会影响输血效果。在输血前的配血工作中,应注意剔除这些疾病导致的干扰因素,保障患者的临床用血。

Objective:To study the relationship between A/G(albumin/globulin)ratio and non-specific aggregation in patients with multiple myeloma and the effect on blood transfusion.Method:A total of 41 samples from the multiple myeloma patients were collected,the antibody screening test was performed by saline medium method to observe whether non-specific aggregation occurred,and the ratio of A/G ratio was calculated.The increase in Hb per unit after transfusion was evaluated;the t-test was used for statistical analysis.Result:27 patients showed non-specific agglutination in the saline,while 14 patients did not aggregate,no IgM-type irregular antibodies were detected in all sample antibody screening.Patients with non-specific aggregation had lower A/G ratios than the patients who did not develop non-specific aggregation(t=-6.457,P<0.001);however,there was no significant difference in Hb elevation per unit after transfusion.Conclusion:The multiple myeloma patients who had a plasma A/G ratio below 0.70 would develop non-specific aggregation in saline media,but would not affect the results of blood transfusion.It should be taken to exclude these interference factors which due to the disease so as to ensure the blood safety for patients.