首页|两种Rh血型系统抗体导致交叉配血不合原因分析与实验室处理策略

两种Rh血型系统抗体导致交叉配血不合原因分析与实验室处理策略

扫码查看
目的 分析RhDC、RhEc抗原阴性患者血清中存在IgG型抗DC及抗Ec联合抗体的血型血清学特点及临床意义。方法 回顾性分析12例血清中存在两种Rh系统不规则抗体的病例的临床资料及实验室检查结果,包括年龄、性别、输血史/妊娠史及血型血清学检测结果(ABO、RhD血型鉴定及Rh分型结果、不规则抗体筛选、抗体特异性鉴定、吸收放散试验、抗体效价测定、交叉配血试验)。结果 12例患者中,年龄(51。4±16。9)岁。9例有输血史,8例有妊娠史,5例既有输血史又有妊娠史。在血型血清学检测中抗体筛选阳性、交叉配血不合。抗体特异性鉴定及吸收放散试验结果显示,3例患者血清中同时存在IgG型抗D、抗C抗体,抗D效价16~32、抗C效价8~16;9例患者血清中同时存在IgG型抗E、抗c抗体,抗E、抗c效价均为8~16;抗D、抗C联合抗体的患者选择ABO同型RhD阴性,其他Rh抗原为ccee的悬浮红细胞,抗E、抗c联合抗体的患者选择ABO同型RhD阳性,其他Rh抗原为CCee的悬浮红细胞,交叉配血试验结果显示,在盐水、聚凝胺、抗人球蛋白介质中均无凝集、无溶血。结论 输血和(或)妊娠免疫是产生两种Rh系统不规则抗体、导致抗体筛选阳性及交叉配血不合的主要原因,ABO同型基础上常规进行Rh配合性输注,对于临床输血的安全性和预防新生儿溶血病的发生具有重要的价值和意义。
Analysis of the causes of incompatible cross-matching induced by two Rh blood group antibodies and corresponding laboratory treatment
Objective To analyze the serological characteristics and clinical significance of IgG anti-D and anti-C combined antibodies and anti-E and anti-c combined antibodies in patients negative for RhDC and RhEc antigens.Methods The clinical data and laboratory results of 12 cases with two types of irregular antibodies were recorded and analyzed,including age,sex,history of blood transfusion/pregnancy,ABO and RhD blood group identification,Rh antigen typing,irregular antibody screening,antibody-specific identification,absorption-elution tests,antibody titer determination and cross-matching tests.Results Among the 12 patients,the mean age was 51.4±16.9 years.Nine patients had a history of blood transfusion;eight patients had a history of pregnancy;five patients had both.Serological tests showed positive antibody screening and incompatible cross-matching.The results of antibody-specific identification and absorption-elution tests showed the presence of both IgG anti-D and anti-C antibodies in three patients,with anti-D titers at 16-32,and anti-C titers at 8-16.Nine patients had both IgG anti-E and anti-c antibodies,with the titers of anti-E and anti-c antibodies at 8-16.From the patients with combined anti-D and anti-C antibodies,suspended red blood cells of ABO identical type,RhD negative and other Rh antigens as ccee were selected.From patients with combined anti-E and anti-c antibodies,suspended red blood cells of ABO identical type,RhD positive and other Rh antigens as CCee were selected.Cross-matching blood test results showed no agglutination or hemolysis in saline,polycoagulant and anti-human globulin media.Conclusion Blood transfusion and/or pregnancy are the primary causes of irregular antibodies in two Rh systems,leading to positive antibody screening and cross-match incompatibility.Routine compatibility transfusion of Rh antigens,based on ABO homotypic blood transfusion,is of great value and significance for the safety of clinical blood transfusion and the prevention of hemolytic disease of the newborn.

Rh blood typeincompatible cross-matchingRh homotypic transfusion

崔颖、张瑜、杨世明、许亚莉、齐霞、邢艳、安宁、王宝燕

展开 >

西安交通大学第一附属医院输血科,陕西西安 710061

唐都医院输血科,陕西西安 710038

空军军医大学第一附属医院输血科,陕西西安 710032

Rh血型 交叉配血不合 Rh同型输注

陕西省自然科学基础研究计划西安交通大学第一附属医院科研发展基金

2024JC-YBMS-7272020ZYTS-23

2024

细胞与分子免疫学杂志
中国免疫学会,第四军医大学

细胞与分子免疫学杂志

CSTPCD北大核心
影响因子:0.817
ISSN:1007-8738
年,卷(期):2024.40(7)