高效价冷凝集素致交叉配血困难分析

[目的]探讨在临床上遇到的高效价冷凝集素致血型鉴定和交叉配血困难的结果分析。[方法]通过临床病历分析、红细胞ABO血型鉴定、复查血型与家系调查、吸收放散试验、血清抗体筛选、抗体鉴定、冷凝集素效价测定、抗人球蛋白试验等血型血清学检测来寻找配血困难原因。[结果]在ABO血型鉴定和交叉配血试验中,献血者和受血者血液中的高效价冷凝集素能遮盖与其同时存在的同种异型抗体,其效价增高是引起意外凝集的常见原因,给血站、临床血库的血型鉴定和交叉配血带来困难,极易引起错误输血,而发生严重的溶血性输血反应。[结论]高效价冷凝集素所致配血不合,应从不同角度思考,选择有价值的鉴别试验,如复核血型、自身抗体吸收试验、抗人球蛋白试验、聚凝胺法交叉配血试验、放散试验等进行多方面排除、鉴定。

ANALYSIS OF HIGH-TITER COLD AGGLUTININS CAUSING CROSS-MATCHING TEST DIFFICULT

[Objective]To study the results of high-titer cold agglutinins causing clinical cross-matching test difficult.[Methods]The result of cross-matching test trouble that high titer cold agglutinins caused was searched by medical record analysis,ABO blood group identification,countercheck blood type,stemma investigation,absorption and irradiation test,serum antibody screening,antibody identification,cold agglutinin titration,antiglobulin test of Coombs,etc.[Results]During ABO blood group identification and Clinical cross-matching test,high-titer cold agglutinins from blood donors and receptors could shade some simultaneous alloantibodies and their high titers could cause unexpected agglutination,which could bring some blood stations and clinic blood banks troubles,blood transfusion error and even severe hemolytic transfusion reaction.[Conclusion]Clinical cross-matching misfit from high-titer cold agglutinins should be thought,depleted and identified by countercheck blood type,autoantibody absorption test,antiglobulin test of Coombs,polybrene cross-matching blood test,irradiation test,and so on.