首页|自身免疫性溶血性贫血(AIHA)患者意外抗体类型与输血疗效相关性分析

自身免疫性溶血性贫血(AIHA)患者意外抗体类型与输血疗效相关性分析

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目的 分析广州地区AIHA患者抗体类型并跟踪输血疗效,为AIHA患者临床输血治疗策略提供参考依据。方法 在 2021 年 1 月—2023 年 10 月本地区医院输血科(血库)送检至本站的 96 份疑难交叉配血标本分析鉴定出 25 份AIHA患者标本,再对其进行血型鉴定、Rh系统的抗原表型分型、抗体筛查及交叉配血,分析AIHA患者抗体类型与输血疗效的相关性。结果 25 份AIHA患者标本中,ABO正反定型相符 17 份,8 份正反定型不符。主侧配血不相合 19(19/25,76%)份,其中直接 Coombs 试验阳性+自身抗体阳性+无特异性抗体阳性 18(18/19,94。7%)份;自身抗体+同种抗体阳性 1(1/19,5。3%)份。主侧配血相合 6(6/25,24%)份,其中自身抗体阳性 3(3/6,50%)份;自身抗体+同种抗体阳性3(3/6,50%)份。25 名AIHA患者中20 名患者有输血治疗并能追踪到输血疗效,5 名患者没有输血治疗或转院而无法追踪。输血有效 11(11/20,55%)例;输血部分有效 6(6/20,30%)例;输血无效3(3/20,15%)例。配血不合病例中,输血有效或部分有效 17(17/20,85%)例。结论 AIHA患者的输血疗效与交叉配血结果并无直接联系,在调节干预自身免疫内环境并排除同种意外抗体导致的配血不相合前提下,配血不合的AIHA患者在充分权衡利弊的情况下,必要时可输血,选择ABO、Rh系统抗原同型血液,可提高输血安全性和有效率。
Correlation between unexpected antibody types and transfusion efficacy in patients with autoimmune hemolytic ane-mia(AIHA)
Objective To analyze the antibody types of autoimmune hemolytic anemia(AIHA)patients in Panyu dis-trict,Guangzhou and track the therapeutic effect of blood transfusion,so as to provide reference for clinical transfusion treat-ment strategy of AIHA patients.Methods From January 2021 to October 2023,96 ambiguous cross-matching blood sam-ples from Blood Transfusion Departments of local hospitals sent to Panyu Central Blood Station were analyzed,and 25 sam-ples of AIHA patients were identified.Then blood group identification,Rh system antigen phenotyping,antibody screening and cross-matching were further performed to analyze the correlation between antibody types and transfusion efficacy in AIHA patients.Results Among the 25 samples of AIHA patients,17 showed consistency between forward and reverse blood grouping and8 showed discrepancy.There were 19(19/25,76%)samples incompatible in cross match on the major side,of which 18(18/19,94.7%)were positive for direct Coombs test,autoantibodies and non-specific antibodies,and1(1/19,5.3%)was positive for autoantibody and alloantibody.There were 6(6/25,24%)samples compatible in cross match on the major side,of which 3(3/6,50%)were positive for autoantibodies,3(3/6,50%)were positive for au-toantibody and alloantibody.Of the 25 AIHA patients,20 received blood transfusion treatment and could be traced,and 5 patients did not receive blood transfusion treatment or transferred to other hospitals and could not be traced.Blood transfu-sion was effective in 11(11/20,55%)cases,partially effective in 6(6/20,30%)cases,and ineffective in 3(3/20,15%)cases.Among the ABO blood group incompatibility samples,transfusion was effective or partially effective in 17(17/20,85%)cases.Conclusion The transfusion efficacy of AIHA patients is not directly related to the results of cross-matc-hing.Under the premise of regulating the autoimmune environment and eliminating the ABO blood group incompatibility caused by unexpected alloantibodies,AIHA patients with incompatible cross-matching can be transfused when necessary,and transfusion of ABO and Rh system antigen homologous blood can improve the safety and efficiency of transfusion.

autoimmune hemolytic anemia(AIHA)unexpected antibodycross matchingtransfusion efficacyGuangzhou

黎淑贞、蓝文莉、马伟文、谢敬文、温吉桃

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广州市番禺区中心血站,广东 广州 511400

自身免疫性溶血性贫血 意外抗体 交叉配血 输血疗效 广州地区

番禺区科技计划预立项目

2021-Z04-076

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(5)
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