【摘 要】
：
目的 探讨排除温自身抗体干扰的血清学方法应用于输血前相容性试验的效果.方法 收集10例温自身抗体影响抗体筛查和抗体鉴定患者的血液标本(全血、血清各3 mL/例),用微热放散法、氯喹放散法或二硫苏糖醇和木瓜酶(ZZAP)试剂处理自身或同种异体红细胞,用处理后的红细胞吸收患者血浆中的自身抗体,并用吸收后的患者血浆及患者红细胞放散液行抗球蛋白法或聚凝胺法抗体鉴定,以确定自身抗体/同种抗体是否具有特异性.为存在同种抗体或特异性自身抗体的拟输血患者选用ABO/Rh同型且不含相应抗原的红细胞血液成分输注,并评估输血疗
【机 构】
：
长沙血液中心,湖南长沙410001;中南大学湘雅二医院;中南大学湘雅三医院
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目的 探讨排除温自身抗体干扰的血清学方法应用于输血前相容性试验的效果.方法 收集10例温自身抗体影响抗体筛查和抗体鉴定患者的血液标本(全血、血清各3 mL/例),用微热放散法、氯喹放散法或二硫苏糖醇和木瓜酶(ZZAP)试剂处理自身或同种异体红细胞,用处理后的红细胞吸收患者血浆中的自身抗体,并用吸收后的患者血浆及患者红细胞放散液行抗球蛋白法或聚凝胺法抗体鉴定,以确定自身抗体/同种抗体是否具有特异性.为存在同种抗体或特异性自身抗体的拟输血患者选用ABO/Rh同型且不含相应抗原的红细胞血液成分输注,并评估输血疗效.结果 10例因原发性或继发性自身免疫性疾病导致产生的温自身抗体影响同种抗体筛查、鉴定的标本,经自身/异体吸收后均排除温自身抗体对标本同种抗体鉴定的影响,检出IgG同种特异性抗体3例(抗-e、抗-Jka、抗-Wra)、特异性自身抗体1例(抗-Ce);10名患者中有6人接受输血治疗,其中4名有特异性抗体的患者输注不含相应抗原的成分血.6例分别输注悬浮红细胞2U后,均为24 h Hb增加值＞10 g/L,且均未发生溶血性输血反应,输血后贫血症状均有所改善.结论 输血患者存在温自身抗体影响同种抗体鉴定时,采用合适的放散法和自体/异体吸收法可排除该种自身抗体的影响,准确鉴定抗体种类和性质,从而有针对性地给患者输血并确保疗效.
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