摘要
目的调查急性溶血性输血不良反应的原因,分析唯酶抗体的检测思路和临床意义,为临床安全输血提供依据。方法对输血后发生溶血反应的患者进行常规急性溶血性输血不良反应追踪调查,通过检测患者药物抗体、G6PD活性以排除其他原因导致的患者溶血。使用两步酶-IAT技术检测并鉴定患者唯酶抗体,进一步对唯酶抗体的相关特征进行文献回顾。结果患者血浆使用常规抗体检测方法结果为阴性,但使用酶法则检出唯酶抗-C,抗-e,患者溶血原因是唯酶抗体导致的溶血性输血反应,在今后的输血过程中应当选择ABO及Rh表型相同的血液进行输注。结论唯酶抗体多数是无临床意义的抗体,偶尔表现同种抗体特异性,文献回顾发现唯酶抗体大多无不良反应。通过文中患者出现急性溶血性输血不良反应的追踪,提供采用酶-IAT(间接抗球蛋白)技术检测有临床意义唯酶抗体的思路,输血时应避开相应抗原,以保障临床安全用血。
Objective To investigate the causes of acute hemolytic blood transfusion adverse reactions, analyze the detection ideas and clinical significance of enzyme-only antibodies so as to provide basis for safe clinical blood transfusion. Methods The patients with hemolysis after transfusion were followed up with routine investigation of acute hemolytic transfusion adverse reactions, and hemolysis caused by other causes was excluded by detecting drug antibodies and G6 PD activity. Two-step enzyme-IAT technique was used to detect and identify patients′ enzyme-only antibodies, and the related characteristics of enzyme-only antibodies were further reviewed. Results The antibody test of patients′ plasma was negative by conventional method, while the enzymatic anti-C and e antibodies were detected by enzymatic method. The hemolysis of the patient was due to hemolytic transfusion reaction caused by enzymatic antibody only, and blood with the same ABO and Rh phenotypes should be selected for transfusion in the future transfusion process. Conclusion Most of enzyme-only antibodies have no clinical significance, but occasionally show homologous antibody specificity. The review of the literature showed that most of the enzyme-only antibodies have no adverse reactions. Through the follow-up of acute hemolytic transfusion adverse reactions in this paper, the idea of using enzyme-IAT(indirect antiglobulin) technique to detect clinically meaningful enzyme-only antibodies was provided, and the corresponding antigens should be avoided during blood transfusion to ensure the safety.
作者
谭金哲
金明艳
陈文珠
王莉
黄春妍
TAN Jinzhe;JIN Mingyan;CHEN Wenzhu;WANG Li;HUANG Chunyan(Department of Transfusion Medicine,West China Hospital of Sichuan University,Chengdu 610041,China;Chengdu Wenjiang District Hospital of Traditional Chinese medicine)
出处
《中国输血杂志》
CAS
2020年第6期597-600,共4页
Chinese Journal of Blood Transfusion
关键词
唯酶抗-C
抗-E
溶血性输血反应
酶-IAT技术
enzyme-only anti-C
e antibody
acute hemolytic transfusion reactive
enzyme-IAT technique
作者简介
并列第一作者:谭金哲;并列第一作者:金明艳;通讯作者:黄春研(1971.02-),女,副主任技师,主要从事输血的临床、教学、科研及管理工作,电话:18980601845,Email:272384160@qq.com。
