745例患者疑难交叉配血检测结果分析

目的：回顾性分析本地区导致临床输血交叉配血不相合产生的原因，为预防溶血性输血反应，保障临床输血安全，拯救病人提供有效依据。方法：对2006-2013年番禺、南沙两区各医院因交叉配血困难而送检的标本745例检测结果进行血型鉴定、不规则抗体筛选和鉴定、交叉配血。结果：ABO血型不合引起的交叉配血不相合15例、血浆蛋白异常引起的交叉配血不相合33例，血型不规则抗体引起的151例。其中ABO血型不合引起配血不相合的A亚型12例，B亚型3例；不规则抗体引起配血不相合分别是：自身抗体57例，药物抗体7例，同种特异性抗体87例．分别为：抗-E31例、抗-cE12例、抗-c5例、抗-Ce1例、抗-M10例、抗-Mur9例、抗-E伴抗-Mur3例、抗-Le^a 5例、抗～Le^b 3例、抗-P16例、抗-Jk^b 2例。结论：本地区导致交叉配血不相合的原因主要是同种不规则抗体，异常血浆蛋白次之，最后是ABO亚型。同种不规则抗体以1Kh血型系统的抗体为主，抗-E比例最多；建议交叉配血试验不配合时，应考虑ABO血型定型是否错误，排除异常血清蛋白影响，开展不规则抗体筛选和鉴定，建立Rh系统数据库，选择相合的血液输注，预防免疫性输血反应，保障临床输血安全。

745 case patients difficult crossmatching test results analysis

Objective ： Retrospectively analyzed the causes of clinical transfusion crossmatch mismatched of Panyu district, to provide an effective basis for the prevention of hemolytic transfusion reaction, for the protection of clinical transfusion safety, and for saving the patient＇ s life. Methods ： Analyze the results of 745 samples after the following tests： blood typing, irregular antibody screening and identification, cross-matching. All the 745 samples were sent to our blood station from hospitals of Panyu and Nansba district because of crossmatch difficulties from 2006 to 2013.Results ： 15 cases of erossmatch mismatched were caused by ABO incompatibility, 33 cases were caused by blood plasma protein abnormalities, 151 cases were caused by irregular blood group antibodies. Blood mismatched which caused by ABO incompatibility with 12 cases of subtype A and 3 cases of subtype B; The reasons of blood mismatched which caused by irregular antibodies were as follows： self-antibodies in 57 cases, drug antibodies in 7 cases, the same kind-specific antibodies in 87 cases, namely ： anti-E 31 cases, anti-c E 12 cases, anti-C 5 cases, anti-Ce 1 cases, anti-M 10 cases, anti-Mur 9 cases, anti-E with anti-Mur 3 cases, anti-Lea 5 cases, anti-Leb 3 cases, anti-P1 6 cases, anti-Jkb two cases. Conclusions ： In Panyu district, the major reason of crossmatch mismatched is the same kind irregular antibodies, followed by abnormal plasma proteins, and finally the ABO subtypes. The same kind irregular antibodies were mainly antibodies of Rh, with max proportion of anti-E. It is recommended that if crossmatch tests do not match, you should consider whether the ABO blood typing error, eliminate abnormal serum proteins influence, carry out irregular antibody screening and identification, establish database of Rh system, select the consistency of the blood transfusion to prevent transfusion reactions, and finally protect the safety of clinical transfusion.