献血员详细血型血清学鉴定必要性调查研究

发布时间：2018-08-02 13:16

【摘要】：目的:对献血员血液进行更加完善的血型血清学检测,减少由于献血员原因造成的红细胞成分血ABO同型交叉配血不相合,从而避免血型血清学检测不合格的血发往临床。方法:1研究对象所研究标本来自沧州市中心血站2014年采集的所有无偿献血者的标本共计65487例,按采集时间将标本分为两个组:其中单月份(1,3,5,7,9,11月份)采集的标本的共计33046例作为对照组;双月份(2,4,6,8,10,12月份)采集的标本共计32441例作为试验组。2实验方法对照组:ABO正反定型:正定型红细胞与抗-A、抗-B反应,反定型试剂A细胞、B细胞与血浆反应。试验组:ABO正定型:正定型红细胞与抗-A、抗-B、抗-A1,抗-AB、抗-Ig G、C3d;反定型A细胞、B细胞、O细胞、S1细胞、S2细胞、S3细胞与献血员血浆反应。结果:两组实验方法在A亚型(不包括A2亚型)检出率方面有显著性差异,试验组可以检出更多的A亚型。两组实验方法在B亚型和AB亚型鉴定方面无显著性差异。两组实验方法在不规则抗体检出率方面有显著性差异,试验组检出了更多的不规则抗体及一定比例的直抗阳性的献血员。两组实验在临床退血方面比较有显著性差异,试验组检测后发出的血液退血率同对照组比较显著降低。结论:在做ABO血型正反定型时,正定型同时加入抗-A1、抗-AB试剂可以提高A亚型(不包含A2亚型)的检出率,反定型加入O细胞和抗体筛选细胞大大提高了献血员血清中Ig M型不规则抗体的检出率。两组试验检验出的血液,试验组发出的血液临床退血率明显低于对照组。直接抗人球蛋白试验检出了献血员中直抗阳性的血液。从而避免交叉配血时出现抗体筛选阴性但配血主侧凝集的现象。
[Abstract]:Objective: to improve the blood type serological test of blood donors, to reduce the mismatch of ABO homotypic cross matching caused by blood donors, so as to avoid blood group serological examination unqualified blood to clinical. Methods A total of 65487 blood donors were collected from Cangzhou Central Blood Station in 2014. The specimens were divided into two groups according to the time of collection: 33046 samples were collected in a single month (1 / 3) as control group; A total of 32441 samples were collected in December as control group (control group .2). The positive and negative typing of positive type erythrocytes and anti-A, anti-B reaction, anti-typing reagent A cell B cell reaction with plasma were observed in the control group (n = 2). The results were as follows: (1) in the experiment group, 2 cases were divided into two groups: control group (n = 2) and control group (n = 2). In the test group, the positive definite pattern of positive type ABO: positive red blood cell and anti--A-, anti--B-, anti--A1, anti--AB-AB, anti--Ig GG C3d; antitype A cell / B cell / S _ 1 cell / S _ 2 cell / S _ 3 cell / blood donor plasma reaction. Results: there was significant difference in the detection rate of A subtype (excluding A2 subtype) between the two groups, and more A subtypes could be detected in the experimental group. There was no significant difference in the identification of subtype B and AB between the two groups. There were significant differences in the detection rate of irregular antibodies between the two groups. More irregular antibodies and a certain proportion of direct anti-positive blood donors were detected in the test group. There was a significant difference between the two groups in terms of clinical blood loss, and the blood degenerative rate of the test group was significantly lower than that of the control group. Conclusion: when ABO blood group is positive and negative, anti-A _ 1 is added into positive typing at the same time. Anti-AB reagent can improve the detection rate of A subtype (not including A2 subtype). By adding O cells and antibody screening cells, the detection rate of Ig M irregular antibody in blood donors was increased greatly. The clinical degenerative rate of blood in the two groups was significantly lower than that in the control group. Direct antiglobulin test detected direct anti-positive blood in blood donors. In order to avoid cross-matching the antibody screening negative but the main side of the blood agglutination phenomenon.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R446.6

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