新生儿脐血ABO血型正反定型及交叉配血实验结果分析

目的探讨婴幼儿ABO正反定型的符合情况及交叉配血试验在婴幼儿输血时的局限性。方法选2010名新生儿的脐血标本,用微柱凝胶血型卡进行正定型,用试管法和纸片法做反定型,用微柱凝胶技术选择异型血与脐血进行交叉配血。结果正定型为A型700份标本中,499份检出抗B,但有39例反应弱,201例未检出抗B,抗B检出率为71.28%(499/700)。正定型为B型的510例标本中,373例检出抗A,但有23例反应弱,137例未检出抗A,抗A检出率为73.13%(373/510)。正定型为O型的800例标本中,只有571例同时检出了抗A和抗B,检出率为71.37%(571/800),131例未检出抗A、抗B,占16.38%(131/800),另有53例仅检出抗A,45例仅检出抗B。选用反定型完全没有凝集的新生儿A、B型的血清各40例分别进行相反血型交叉配血试验,即A(B)型血清 B(A)型红细胞,在这80例的配血结果中:盐水配血法全部阴性,聚凝胺配血法有2例弱阳性,微柱凝胶技术配血法发现有8例弱阳性。结论新生儿ABO血型鉴定中大部分已正反定型相符,在新生儿常规血型检查时反定型的价值不可忽视。微柱凝胶抗人球蛋白技术能有效地发现微弱的血型抗体,是一种较为敏感、安全的方法。

ABO Blood Group Typing and Cross Matching in Neonate Cord Blood Samples

Objective To discuss coincidence of the blood group typing and reversed typing,and the limits of the cross matching in the neonate cord blood samples.Methods Blood group typing by micro-column gel agglutination assay(MGAA) and reversed typing by tube test or slip test on the selected 2 010 cord blood samples from the neonates.Results In the 700 samples typed as A,the anti-B antibody positive rate was 71.28%(499/700),but with 39 weak reactions.In the 510 samples typed as B,the anti-A antibody positive ratewas 73.13%(373/510),but with 23 weak reactions.In the 800 samples typed asO,the rate of both anti-A and anti-B positive was only 71.37%(571/800),and anti-A positive was only 6.63%(53/800),anti B positive was only 5.62%(45/800),and the rest 13116.38%(131/800)]samples had no detectable anti-A or anti-B.40 samples typed A group but with no anti-B performed cross matchingwith B donated blood,and another 40 samples typed B group but with no anti-A performed cross matching with A donated blood,show all negative in saline,two weak positive in polybrene,and 8 weak positive in MGAA.Conclusion The reversed blood typing in neonate can not be neglected because the ABO antibodies in most of them have been formed.MGAA can find weak blood group antibodies and be as a sensitive method.