直接抗人球蛋白试验阳性患者的配血及成分输血

摘要

目的 分析直接抗人球蛋白试验阳性(DA T)输血患者的病理特征,探讨解决疑难配血的方法 ,从而为患者选择合适的血液成分.方法对73例DA T阳性的标本采用吸收、放散试验排除自身抗体和同种抗体的干扰,进一步鉴定不规则抗体的特异性.对有同种抗体的患者选择不含相应抗原的红细胞进行交叉配血,根据患者有无自身免疫性溶血选择不同的血液成分.结果 73例中,除9例自身免疫性溶血性贫血输注洗涤红细胞外,其他患者输注悬浮少白细胞红细胞后,贫血症状明显改善,无溶血性输血反应发生.结论 对DA T阳性患者需采用吸收、放散试验,排除自身抗体或同种抗体干扰后,根据患者有无溶血而选择相应的成分输血.%Objective To analyze the pathological characteristics of the patients with direct against people globulin test positive and search for the solution of blood matching and component blood transfusion .Methods The absorption and radiation tests were performed for excluding the interference of autoantibody and iso-antibody in 73 patients with direct against people globulin test positive .The irregular antibody specificity was identified further .Blood match was performed using RBC without corresponding antigen in the patients having the iso-antibody .The different blood components were chosen according to the patients with or without autoimmune hematolysis .Results Of 73 cases ,washing red blood cells were infused in 9 cases with autoimmune hemolytic anemia and the other 64 cases received red blood cells with suspended less white blood cells ,after which the symptoms of anemia were improved remarkably without transfusion-induced hemolysis response . Conclusion The absorption and radiation tests are needed in the patients with direct against people globulin test positive .After excluding the interference of autoantibody or iso-antibody ,the suitable component blood transfusion can be chosen according to with or without autoimmune hematolysis of the patients with direct against people globulin test positive .