422例ABO正反定型不符的原因分析及处理对策

发布时间：2018-02-16 08:19

本文关键词： ABO血型 ABO正反定型不符原因分析处理对策　出处：《中国输血杂志》2016年05期 　论文类型：期刊论文

【摘要】：目的分析422例患者ABO正反定型不符的原因及处理对策。方法随机使用GRIFOLS ERYTRA、BIO-RAD IH-1000全自动血型仪采用微柱凝胶法检测患者ABO血型26 923例,检出ABO正反定型不符的标本422例。联合分析实验技术原因、患者临床资料以及针对性辅助实验进行ABO血型鉴定。结果 422例检出ABO正反定型不符,其中325例为ABO血型不合造血干细胞移植患者。除造血干细胞移植患者外,正反定型不符的患者有97例,正定型减弱或缺失患者40例,其中恶性血液病患者24例,在正定型减弱或缺失中占60%(24/40);反定型减弱或缺失者9例,正定型额外反应者6例,反定型额外反应者36例,正定型、反定型同时额外反应者6例;检出自身抗体患者21例,在正反定型额外反应中占43.8%(21/48)。结论本研究病例中引起ABO正反定型不符的主要原因有ABO血型不合造血干细胞移植、恶性血液病以及自身抗体(假阳性)。根据ABO正反定型不符的实验室技术原因、患者临床资料以及针对性辅助实验可以正确鉴定血型,明确患者的ABO血型,从而指导临床输血的选择。
[Abstract]:Objective to analyze the causes and countermeasures of ABO positive and negative typing in422 patients. Methods GRIFOLS ERYTRABIO-RAD IH-1000 automatic blood type instrument was used to detect ABO blood type in 26 923 patients by microcolumn gel method. 422 cases of positive and negative ABO typing were detected. The technical reasons of the experiment, the clinical data of the patients and the specific auxiliary experiment were analyzed for ABO blood type identification. Results the positive and negative types of ABO were detected in 422 cases. Among them, 325 cases were ABO blood group incompatible hematopoietic stem cell transplantation patients. In addition to hematopoietic stem cell transplantation patients, 97 cases were positive and negative typing patients, 40 cases were positive type weakening or missing patients, including 24 cases of malignant hematologic diseases. The proportion of positive type weakening or missing is 60 / 24 / 40%; there are 9 cases of negative type weakening or missing, 6 cases of positive type extra reaction, 36 cases of anti-type extra reaction, 6 cases of positive type and 6 cases of simultaneous extra reaction of anti-typing; 21 cases of autoantibodies are detected. Conclusion in this study, the main cause of positive and negative ABO mismatch is ABO blood group incompatible hematopoietic stem cell transplantation. Malignant hematological diseases and autoantibodies (false positive). According to the laboratory technical reasons that ABO does not match positive and negative typing, patients' clinical data and targeted auxiliary experiments can correctly identify blood groups and determine patients' ABO blood groups. So as to guide the selection of clinical blood transfusion.
【作者单位】：北京大学人民医院输血科;北京市红十字会血液中心;
【基金】：卫生部医政司医疗机构输血科(血库)质量管理规范项目(2098006) 北京大学人民医院研究与发展基金(2118000596)资助
【分类号】：R457.11

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