Blood group identification, antibody screening and cross-matching detection methods and results analysis of anemia caused by acute leukemia
-
摘要: 目的:研究急性白血病引起的贫血患者血型鉴定、抗体筛查及交叉配血的检测方法。方法:选取2015-05-2018-05收治的200例急性白血病引起的贫血患者,做血型鉴定、抗体筛查及交叉配血输血前3项检查,记录自身抗体分型、ABO和Rh血型鉴定结果,温型、冷型及混合型抗体的筛选和鉴定,交叉配血结果。结果:200例急性白血病引起的贫血患者中,温抗体、冷抗体、混合型抗体分别为128例(64.00%)、50例(25.00%)、22例(11.00%)。血型鉴定中反定型存在48例抗体干扰,正定型89例抗体干扰。交叉配血的50例冷抗体患者中,有特异性自身抗体17例(34.00%),PEG-IAT法配血全部成功;无特异性自身抗体33例(66.00%),PEG-IAT法配血成功30例(90.90%),Coombs法符合者3例(9.10%)。混合型抗体阳性患者22例中,自身抗体+同种抗体4例(18.18%),Coombs法配血全部成功;无特异性自身抗体18例(81.82%),其中PEG-IAT法配血成功15例(83.33%),Coombs法符合者3例(16.67%)。温抗体阳性患者128例中,无特异性自身抗体29例(22.66%),其中PEG-IAT法配血成功21例(72.41%),Coombs法符合者8例(27.59%);特异性自身抗体21例(16.41%),PEG-IAT法配血全部成功;自身抗体+同种抗体78例(60.94%),其中PEG-IAT法配血成功2例(2.56%),Coombs法符合者76例(97.44%)。结论:急性白血病引起的贫血患者在输血时所做的输血前3项检查中,选择合适的检测方法能降低检测成本,提高检验效率及安全性,降低输血时发生不良反应的风险。Abstract: Objective: To study the blood group identification, antibody screening and cross-matching method for patients with anemia caused by acute leukemia.Method: A total of 200 patients with anemia caused by acute leukemia from May 2015 to May, 2018 were selected for blood group identification, antibody screening and cross-matching blood transfusion.The results of autoantibody typing, ABO and Rh blood group identification, screening and identification of warm, cold and mixed antibodies and cross-matching were recorded.Result: Of the 200 patients with anemia caused by acute leukemia, the warm, cold and mixed antibody were 128 cases(64.00%), 50 cases(25.00%) and 22 cases(11.00%), respectively.There were 48 cases of antibody interference in the anti-type of blood type identification, and 89 cases of antibody interference in positive type.Among the 50 cold antibody patients with cross matching, there were 17 cases(34.00%) with specific autoantibodies, all of which were successfully matched by PEG-IAT method;33 cases(66.00%) without specific autoantibodies, PEG-IAT method with blood 30 cases were successful(90.90%) and 3 cases(9.10%) were consistent with the Coombs method.Among the 22 patients with mixed antibody positive, autoantibody+allogeneic antibody in 4 cases(18.18%), Coombs method was all successful;18 cases(81.82%) had no specific autoantibodies, and 15 cases(83.33%) were successfully matched by PEG-IAT method Coombs method was consistent with 3 cases(16.67%).Among the 128 patients with positive warm antibody, there were 29 cases(22.66%) without specific autoantibodies, 21 cases(72.41%) with PEG-IAT method, and 8 cases(27.59%) with Coombs method;specific autoantibodies in 21 cases(16.41%), the PEG-IAT method was successfully matched with blood;autoantibody + alloantibodies in 78 cases(60.94%), PEG-IAT method in 2 cases(2.56%), and Coombs method in 76 cases(97.44%).Conclusion: In the first three blood transfusion tests of patients with anemia caused by acute leukemia, choosing the appropriate test method can reduce the cost of testing, improve the efficiency and safety of testing, and reduce the risk of adverse reactions during transfusion.
-
Key words:
- acute leukemia /
- anemia /
- blood type identification /
- antibody screening /
- cross matching
-
-
[1] Ventura Ferreira MS, Crysandt M, Ziegler P, et al.Evidence for a pre-existing telomere deficit in non-clonal hematopoietic stem cells in patients with acute myeloid leukemia[J].Ann Hematol, 2017, 96:1457-1461.
[2] 李先梅, 张友山, 梁彩霞, 等.循证护理干预在急性白血病患者化疗后的应用[J].实用临床医药杂志, 2017, 21(24):201-202.
[3] 张广吉, 李巍, 林冬, 等.急性白血病患者血流感染的临床特征及治疗策略[J].中华医院感染学杂志, 2016, 26(17):3959-3962.
[4] 魏斌, 贾永清, 陈安心, 等.不同剂量血小板预防性输注白血病患者出血风险的评估[J].临床血液学杂志, 2016, 29(12):1000-1001.
[5] 陈雪瑜.地西他滨联合CAG方案治疗老年急性髓系白血病的效果及对患者免疫功能的影响[J].中国老年学, 2017, 37(14):3500-3502.
[6] 沙吉代木·买买提, 谢姆孜牙·买买提热夏提, 桂霞.肿瘤患者血型不规则抗体的分析[J].临床血液学杂志, 2015, 28(12):1028-1029.
[7] Pierfranceschi MG, Imberti D, Orlando S, et al.Effectiveness of recombinant activated factor VII in haemorragic cancer-related disseminated intravascular coagulation:A case report[J].Thromb Res, 2011, 125:S186-S187.
[8] Li Y, Wang Y, Liu H, et al.Lower level of IL-35 and its reduced inhibition in Th17 cells in patients with bone marrow mononuclear cells Coombs test-positive hemocytopenia[J].Mol Med Rep, 2018, 17:2973-2981.
[9] 张璐, 袁红, 伍钢.抗M抗体、抗Lea抗体以及自身冷抗体引起的输血交叉配血不合1例[J].临床血液学杂志, 2017, 30(4):325-326.
[10] 周映君, 韦喜敢, 周吉成, 等.CD36抗原缺失与血小板输注无效关系的研究进展[J].临床血液学杂志, 2016, 29(10):851-854.
[11] Dinardo CL.Red blood cell alloantibodies and autoantibodies:different presentation, same physiopathology[J].Hematol Transfus Cell Ther, 2018, 40:99-100.
[12] 李笃军, 王新光, 陈海霞, 等.输血前不规则抗体筛查对临床安全输血的意义[J].临床血液学杂志, 2015, 28(1):103-104.
[13] Jain A, Agnihotri A, Marwaha N, et al.Direct antiglobulin test positivity in multi-transfused thalassemics[J].Asian J Transfus Sci, 2016, 10:161-163.
[14] 傅立强, 桑列勇, 朱守兵.微板抗人球蛋白法在献血者不规则抗体筛查中的应用[J].临床血液学杂志, 2016, 29(12):976-977.
-
计量
- 文章访问数: 393
- PDF下载数: 713
- 施引文献: 0