不规则抗体导致ABO血型正反定型不符112例分析

摘要

目的：探讨导致ABO血型正反定型不符的不规则抗体特异性及其免疫球蛋白类型。方法：采用微柱凝胶法对患者进行ABO和RhD血型鉴定，对ABO血型正反定型不符的血标本再采用试管法进行复检，检测免疫球蛋白类型。结果：常规检测中有112例标本出现正反定型不符，进行的不规则抗体检测显示，MNS、P、Lewis、Kidd、Rh血型系统都有标本出现，33.9%出现抗M抗体，10.8%出现抗P抗体，26.8%出现Lewis抗体；Kidd抗体8例(7.1%)；Rh抗体20例(17.9%)；12.5%为冷自身抗体。进行效价及免疫球蛋白检测结果显示：IgM型抗体效价1：16～1：8192，占75.0%；17.9%为IgG型，7.1%为IgM、IgG混合型，抗体效价分别为1：32～1：256、1：32～1：256。结论：IgM型不规则抗体是导致ABO血型正反定型不符主要原因，高效价的IgG型不规则抗体也可引起ABO血型正反定型不符，在ABO血型鉴定中必须正反定型，同时进行不规则抗体筛选才能保证检测结果的准确性和临床输血安全。%[ABSTRACT]Objective: To explore the causes of ABO blood group typing discrepancies of irregular antibody specificity and immunoglobulin type.Methods:ABO and RhD blood group identiifcation of patients with micro column gel method, of ABO blood group typing discrepancies of blood samples by test tube method for re examination and detection of immunoglobulin protein type.Results:Conventional detection,112 cases were positive and negative stereotypes do not match, the detection of irregular antibodies display, MNS, P, Lewis, Kidd, Rh blood group system have specimens, anti-M antibody 33.9%, 10.8% P antibody, 26.8% appear Lewis antibody; Kidd antibodies in 8 cases (7.1%); Rh antibodies in 20 cases (17.9%), 12.5% for cold autoantibodies. For titer and immune globulin test results showed that the IgM antibody titer of 1:16~1:8192, accounting for 75%; 17.9% IgG, 7.1% IgM, IgG hybrid, the antibody titer was 1:32~1:256, 1:32~1:256.Conclusion:IgM irregular antibody is lead to ABO blood group typing discrepancies main reason, irregular high titer of IgG type antibody can also induces the inconsistent of ABO blood group typing, in ABO blood group identiifcation must be positive and negative stereotypes and irregular antibody screening in order to ensure the accuracy of test results and clinical blood transfusion safety.