高效价自身冷抗体致血型鉴定和交叉配血困难的处理方法

目的：探讨高效价的自身冷抗体致血型鉴定和交叉配血困难的处理方法。方法：对高效价自身冷抗体致血型鉴定和交叉配血困难的患者,通过ABO血型鉴定、冷抗体效价滴定、血清抗体筛查、抗人球蛋白试验以及凝聚胺和微柱凝胶交叉配血等血清学检测,寻找血型鉴定和交叉配血困难的原因,并提出相对应的处理方法。结果：收集由于高效价自身冷抗体引起血型鉴定和交叉配血困难共7例,其中6例患者冷抗体效价在128～256之间,通过37℃水浴,血型鉴定正反定型一致,交叉配血相合;1例患者冷抗体效价为1024,通过37℃加热洗涤和4℃冷吸收之后进行血清学试验,血型鉴定正反定型一致,交叉配血相合。结论：高效价自身冷抗体引起的血型鉴定和交叉配血困难时,可以根据自身冷抗体效价的高低以及冷凝集强度,选择37℃水浴或37℃加热洗涤、4℃冷吸收等不同鉴别试验进行排除,以期达到正确的血型鉴定和有效的交叉配血,保证临床输血安全。

Treatments of discrepancy among blood typing and cross-matching test caused by high-titer cold antibodies

Objective：To investigate treatments of discrepancy among blood typing and cross-matching test caused by high-titer cold antibodies.Method：ABO typing,cold antibody titration,serum antibody screening,antiglobulin test of Coomb＇s and cross-matching test with Polybrene and microcolum gel were used to analyze the troubles of blood typing and cross-matching caused by high-titer cold antibodies,then some corresponding methods were given.Result：Seven samples with contradiction of blood typing or cross-matching caused by high-titer cold antibodies were collected.After the RBCs were incubated at 37℃,six（titer 128~256） of those had coincident results between cell typing and sera typing,and the cross-matching tests were matched.While the other one sample with high cold antibodies（titer 1024） appeared the correct result after its RBCs were washed at 37℃ and cold absorbed at 4℃.Conclusion：High-titer cold antibodies might result in some troubles of blood typing and cross-matching test.According to the titer and intensity of the agglutinins,incubation at 37℃,washing at 37℃ and/or cold absorption at 4℃ might be used to get correct blood typing results and efficient cross-matching,which would help to ensure the safety of clinical transfusion.