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摘要: 此文患者因进行输血前检测时出现正反定型不符,遂通过血清学方法对患者血样进行血型鉴定、抗体筛选鉴定、交叉配血等实验。观察患者血清在不同温度下与红细胞的反应,发现血清在常温下与A、O型红细胞凝集强度分别为w+、4+,在37℃时与A、O型红细胞无凝集;抗体筛查实验,在22℃盐水介质下,与Ⅰ、Ⅱ、Ⅲ号细胞均有凝集,37℃时均无凝集;在室温时与谱细胞凝集阳性,37℃下与谱细胞凝集阴性;在室温下与成人O型红细胞反应4+,与成人A型红细胞反应1+,与脐带血红细胞无凝集反应。确定患者血浆中含有抗-HI抗体。Abstract: In this study, a patient presented with ABO blood group discrepancy during pre-transfusion testing. Serological methods were employed to identify the patient's blood type, antibody screening and crossmatching experiments were done. The patient's serum reactivity with red blood cells at different temperatures was observed. It was found that the serum agglutinated strongly with A and O type red blood cells at room temperature(w+ and 4+ reactions, respectively) but did not agglutinate at 37℃. Antibody screening experiments in a saline medium at 22℃ resulted in agglutination with cells Ⅰ, Ⅱ and Ⅲ, while no agglutination occurred at 37℃. Furthermore, agglutination was positive with panel cells at room temperature but negative at 37℃. The patient's serum reacted with adult O type red blood cells at a 4+ level, with adult A type red blood cells at a 1+ level, and showed no reactivity with cord blood red cells. These confirmed the presence of anti-HI antibodies in the patient's plasma.
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Key words:
- anti-HI /
- antibody /
- blood typing
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表 1 患者ABO血型鉴定
反应条件 抗-A 抗-B AC BC OC 自身 室温 4+ 0 w+ 4+ 4+ 0 37℃ 0 4+ 0 表 2 患者血浆与抗体筛选细胞反应格局
序号 Rh-hr Kidd MNS Duffy Lewis P 患者 D C E c e Jka Jkb M N S s Fya Fyb Lea Leb P1 NS 22℃ AHG 37℃ 1 + 0 + + 0 + 0 + 0 0 + + + 0 + 0 4+ 0 2 + + 0 0 + + + + + 0 + + 0 + + 0 4+ 0 3 + + + + + 0 + + 0 + + + 0 + + + 4+ 0 表 3 患者血浆与谱细胞反应格局
谱细胞 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 22℃ 4+ 3+ 4+ 4+ 3+ 4+ 3+ 4+ 4+ 3+ 4+ 4+ 4+ 4+ 3+ 4+ 37℃ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 表 4 特异性冷抗体鉴定
项目 O1 O2 O3 A1 A2 A3 脐血O1 脐血O2 22℃ 4+ 4+ 4+ 1+ 1+ 1+ 0 0 -
[1] 马春娅, 张晓娟, 王金慧, 等. 抗-HI抗体的筛查和鉴定在临床输血中的应用价值[J]. 国际检验医学杂志, 2017, 38(22): 3094-3096. doi: 10.3969/j.issn.1673-4130.2017.22.008
[2] Zhu Z, Hong K, Ke Y. The effects of anti-CD38 monoclonal antibody and anti-HI antibody on pretransfusion testing in a patient with multiple myeloma[J]. Ann Hematol, 2023, 102(7): 1961-1962. doi: 10.1007/s00277-023-05251-0
[3] Irani MS, Richards C. Hemolytic transfusion reaction due to anti-IH[J]. Transfusion, 2011, 51(12): 2676-2678. doi: 10.1111/j.1537-2995.2011.03209.x
[4] Hinton R, Haji R, Kaczmarski R, et al. Hyperhaemolysis caused by anti-HI antibodies in a patient with myelodysplastic syndrome following a first ever red cell transfusion[J]. Transfus Med, 2023, 33(4): 349-351. doi: 10.1111/tme.12971
[5] 张黎雯, 李树中, 田丰, 等. 红细胞血型抗原的最新研究进展[J]. 临床血液学杂志, 2021, 34(2): 135-144. https://lcxy.whuhzzs.com/article/doi/10.13201/j.issn.1004-2806.2021.02.016
[6] 杰夫·丹尼尔. 人类血型(第2版)[M]. 北京: 科学出版社, 2007.
[7] Yan HX, Hale J, Jaffray J, et al. Developmental differences between neonatal and adult human erythropoiesis[J]. Am J Hematol, 2018, 93(4): 494-503. doi: 10.1002/ajh.25015
[8] Dimitroff CJ. I-branched carbohydrates as emerging effectors of malignant progression[J]. Proc Natl Acad Sci USA, 2019, 116(28): 13729-13737. doi: 10.1073/pnas.1900268116
[9] Song M, Zhao SM, Jiang TL, et al. A very rare case with particular H-deficient phenotypes[J]. Indian J Hematol Blood Transfus, 2018, 34(4): 788-791. doi: 10.1007/s12288-018-0915-3
[10] 杜娟, 江涛, 杨世明, 等. 抗HI抗体的鉴定及其对输血相容性检测结果的影响[J]. 细胞与分子免疫学杂志, 2020, 36(10): 930-933. https://www.cnki.com.cn/Article/CJFDTOTAL-XBFM202010012.htm
[11] Koh YE, Ryu GY, Kim YH, et al. Anti-H antibody showing agglutination in the anti-human globulin phase in a Korean patient[J]. Ann Lab Med, 2016, 36(3): 284-286. doi: 10.3343/alm.2016.36.3.284
[12] Shao LN, Song WQ, Wang N, et al. Incidental discovery of anti-IH in a patient planned for Caesarean section and it's repercussions[J]. Indian J Hematol Blood Transfus, 2018, 34(2): 368-369. doi: 10.1007/s12288-017-0891-z
[13] Subramaniyan R. AB Para-Bombay phenotype: a rare blood group variant and its clinical significance[J]. Hematol Transfus Cell Ther, 2018, 40(1): 96-97. doi: 10.1016/j.htct.2017.11.003
[14] Ibanez C, Habibi A, Mekontso-Dessap A, et al. Anti-HI can cause a severe delayed hemolytic transfusion reaction with hyperhemolysis in sickle cell disease patients[J]. Transfusion, 2016, 56(7): 1828-1833. doi: 10.1111/trf.13611