混合抗体型自身免疫性溶血性贫血的血型定型和抗体鉴定

【目的】 建立合适的方法解决混合抗体型自身免疫性溶血性贫血的血型定型和抗体鉴定? 【方法】 分离标本的血清和红细胞,将红细胞进行轻度热放散和氯喹放散实验后,用于ABO正定型?Rh血型抗原分型和后续的自身吸收实验;取适量患者血清,加入等量O型红细胞进行抗体吸收,吸收后的血清用于ABO反定型实验;分别采用PEG法和自身吸收法对自身抗体进行吸收,比较两者的吸收时间?吸收次数?吸收后血清抗体鉴定结果;取适量红细胞进行乙醚放散,放散液用于抗体鉴定? 【结果】 21例患者的ABO血型得到正确鉴定,15例患者的Rh血型进行了正确定型?2种吸收方法处理后的血清抗体检测结果一致:检出自身抗体合并同种抗体7例,其中4例同种抗体得到确认,3例同种抗体特异性未明确;单纯自身抗体14例?PEG法总吸收时间为825 min,平均为39.3 min;总吸收次数55次,平均每例吸收2.6次;自身细胞放散后吸收实验总耗时为2 070 min,平均为98.7 min;总吸收次数66次,平均每例吸收3.1次? 【结论】 轻度热放散结合氯喹放散法适用于混合抗体型AIHA患者血型定型前的红细胞处理;PEG吸收法快速?简便?吸收效果好,适合用于临床实际工作?

Blood Group Typing Test and Antibody Identification of Autoimmune Hemolytic Anemia with both Warm and Cold Autoantibodies

【Objective】 To resolve the difficulty in blood group typing test and antibody identification test of autoimmune hemolytic anemia (AIHA) with both warm and cold autoantibodies. 【Methods】 Patient′s RBC was used for ABO and rhesus typing test after it had been eluted with gently heat and chloroquine. The ABO reverse typing test was performed after the autoantibodies in patient′s plasma had been absorbed with O group blood cell. Polyethylene glycol (PEG) adsorption method and auto-adsorption method were studied by comparing the total time and numbers of the adsorption. Antibodies were identified with ethylether elute. 【Results】 ABO and Rh blood group were typed correctly in 21 and 15 cases, respectively. Seven cases were detected to have both allo-antibody and auo-antibody, including anti-S, anti-Ce, anti-c and anti-E, however, antibodies specificity had not been identified in 3 cases. Fourteen cases had only autoantibody. The mean time required by PEG adsorption and auto-adsorption for autoantibody removal was 39.3 minutes (total, 825 minutes) and 98.7 minutes (total, 2 070 minutes). The mean number of autoadsorption for removing autoantibody were 2.6 (total, 55) and 3.1 (total, 66). 【Conclusion】 Gently heat elute combines chloroquine elute is a good choice to perform blood group typing test for AIHA patients with both cold and warm autoantibodies. PEG method is a rapid, simple and effective way to remove autoantibody and detect underlying alloantibody, which can be used in routine practice.