大量输注多种抗体红细胞但无不良反应的输血分析

目的分析一例临床配血不合的不明抗体的成分和来源,探讨大量输注配血不合红细胞而没有导致输血不良反应的原因。方法对患者血浆做血型鉴定、直抗、抗筛、抗体鉴定和抗体效价测定等血清学试验。结果患者血浆中同时存在效价高达1∶1024的抗-I为主的多种抗体,包括特异性抗体和药物抗体且已激活补体,造成配血不合。结论大量配血不合红细胞的输注并没有引起明显输血不良反应,临床输血应根据患者病情灵活调整输血方案。

Analysis of massive transfusion of antibody red blood cells without adverse reactions

Objective To analyze the composition and source of an unidentified antibody in a case of clinical mismatching,and to explore the cause of a large number of transfusion mismatched red blood cells without adverse reactions.Methods Blood group identification,direct antibody,anti screen,antibody identification and antibody titer determination were performed in patients′plasma.Results There were many kinds of anti-I antibodies with titer up to 1∶1024 in the plasma of patients,including specific antibodies and drug antibodies,and the complement had been activated,resulting in blood matching incompatibility.Conclusion The transfusion of a large number of mismatched red blood cells does not cause obvious adverse reactions of blood transfusion.The transfusion scheme should be adjusted flexibly according to the patients′condition.