摘要
目的:观察先天性中性粒细胞减少症患儿移植前后多次输注红细胞产生的血清学改变,探讨其交叉配血策略。方法:1例脐带血干细胞移植术后多次输注红细胞效果不理想的先天性中性粒细胞减少症患儿,采用盐水介质法鉴定患儿ABO血型及Rh表型,采用盐水介质法、凝聚胺介质法和微柱凝胶法对该患儿进行血清红细胞放散液抗体鉴定及主侧交叉配血。临床随访观察使用交叉配血合格的血液后,该患儿的血红蛋白浓度变化。结果:该患儿ABO表型正定型为A型,反定型中A细胞和自细胞呈现弱凝集,Rh血型表型为CCDee。患儿血清中存在Rh血型系统类抗-Ce抗体,同时产生类抗-A抗体,选择输注O型Rh表型为ccDEE的洗涤红细胞1U后血红蛋白由88g/L升高至96g/L,且未出现输血不良反应。结论:运用不同血型血清学方法,能较准确地鉴定出患者血清中存在的同种抗体,提高输血安全。
Objective:To explore the cross-matching strategy of a case of a child with congenital neutropenia who received multiple red blood cell infusions before and after transplantation with mimicking antibodies of anti-Ce and anti-A.Method:The saline medium,polybrene medium and microcolumn gel method were used to identify the antibody of serum and disseminated fluid.The saline medium method was used to identify the ABO blood group and Rh phenotype.The saline medium,polybrene medium and microcolumn gel method were used for main side cross-matching.The follow-up clinical observation was carried out to find the difference of hemoglobin concentration.Results:The ABO phenotype of the child was type A,and the A cells and autocells showed weak agglatination in the reverse type.The mimicking antibody of anti-Ce and anti-A were present in Rh blood group system of this child.The washed red blood cells with type O and Rh phenotype of ccDEE were recommended for the patient with mimicking anti-A and anti-Ce antibodies.The concentration of hemoglobin of the patient was increased from 88g/L to 96g/L,no transfusion side-effects were found.Conclusion:The different serological methods of blood group identification can be used to accurately identify the alloantibodies present in the patient's serum,in order to improve the accuracy of clinical transfusion.
作者
瞿珍
包安裕
许婷婷
沈钢
何鸣镝
QU Zhen;BAO An-yu;XU Ting-ting;SHEN Gang;HE Ming-di(Wuhan Blood Center, Wuhan 430030, China;Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China)
出处
《微循环学杂志》
2020年第4期64-67,共4页
Chinese Journal of Microcirculation
基金
湖北省卫健委科研项目(WJ2019H349)
武汉市卫健委科研项目(WX19Q02)。
关键词
类抗体鉴定
交叉配血
多次输血
Identification of mimicking antibodies
Blood cross-matching
Multiple transfusion
