不同放散试验对新生儿ABO溶血病的诊断价值对比

摘要 目的：分析与比较不同放散试验对新生儿ABO溶血病的诊断价值。方法：选择2017年9月至2019年6月在本院进行ABO溶血病检测的新生儿240例,取所有新生儿的静脉血样本2~3 mL,采用冷冻复融放散试验方法与改良热放散试验方法检测新生儿ABO溶血病的发生情况,并比较单独诊断和联合诊断的价值。结果：在240份标本中,冷冻复融放散试验检出新生儿ABO溶血病阳性130例,阳性检出率为54.2 %;改良热放散试验检出新生儿ABO溶血病阳性94例,阳性检出率为39.2 %;二者联合检出新生儿ABO溶血病阳性100例,阳性检出率为41.67 %,联合检出新生儿ABO溶血病阳性率和冷冻复融放散试验检出新生儿ABO溶血病阳性率显著高于改良热放散试验检出新生儿ABO溶血病阳性率(P<0.05)。临床最终诊断为新生儿ABO溶血病101例,阳性率为42.08 %,患儿ABO血型包括A型56例,B型45例。冷冻复融放散试验诊断新生儿ABO溶血病的敏感性和特异性为73.8 %和95.5 % ,ROC曲线面积0.775;改良热放散试验检诊断为新生儿ABO溶血病的敏感性和特异性为100 %和95.2 %,ROC曲线面积0.853;二者联合诊断对新生儿ABO溶血病的敏感性和特异性为90.0 %和97.85 %,ROC曲线面积0.872,联合诊断特异性优于改良热放散试验检诊和冷冻复融放散试验诊断,且改良热放散试验检诊敏感性优于冷冻复融放散试验诊断。结论：相对于冷冻复融放散试验,改良热放散试验对新生儿ABO溶血病的诊断敏感性更高,且不影响诊断特异性,两种放散方法联合检测具有更好的应用价值。     

Maternal IgG anti-A and anti-B titres predict outcome in ABO incompatibility in the neonate

Hemolytic disease of newborn (HDN) is an alloimmune hemolytic disease which occurs due to red blood type incompatibility between mother and fetus. An AB blood type neonate was admitted to Shengjing hospital with severe anemia. Major crossmatch incompatibility was found with some random donors. Serological tests were administered to the neonate and his parents. The mother was B blood type, while the father was AB blood type. The neonate's direct antiglobulin test (DAT) was negative, but the elution test was positive with A₁ cell and negative with A₂ cell. Titers 64 anti-A₁ and 2 anti-A in the mother's serum were detected after treated by dithiothreitol (DTT). The mother's red cells showed a weak agglutination with anti-A under microscopy. The neonate was diagnosed with HDN. After phototherapy and A₂B red blood cell (RBC) transfusion, the neonate was discharged with a recovery of his hemoglobin and physiological index. This study describes a rare case of HDN caused by anti-A1 allo-antibodies.     

Serological and molecular analysis of ABO and Rh blood group chimeras

The serological examination, blood transfusion strategies and the molecular analysis to blood group chimera were conducted to demonstrate existent of chimera in blood group. The blood grouping of ABO or/and RhD, newborn red blood cells separated by capillary centrifugation. Aabsorption tests and DTT treated agglutination erythrocyte tests were implemented in four patients. Further molecular biological research was conducted on one patient''s sample. The results showed that for patient 1: ABO blood group was AB/B chimera, Rh blood cells contained the RhCE chimera gene; Patient 2: Rh blood cells contained the RhD chimera gene; Patient 3: ABO blood group was AB/B chimera, Rh blood cells contained the RhD chimera gene; Patient 4: ABO blood group was O/B chimera, Rh blood cells contained the RhCE chimera gene. The study suggests that the individuals categorized as chimeras are likely to be more common than existing literature reports. According to the serological tests, in the absence of a history of recent blood transfusion or disease to cause reduced antigen, the phenomena of hybrid aggregation of the ABO and Rh blood system were the main feature. In terms of transfusion strategy, the selection of ABO and Rh blood groups should be depended on the group of cells with more antigens.     

Blood transfusion and lung surgeries in pediatric age group: a single center retrospective study

Incompatibility of blood groups or unexpected antibodies are primary considerations when acute hemolysis occurs during or after transfusion. However, less attention is paid to drug-induced immune hemolytic anemia (DIIHA), which is a rare but potentially life-threatening autoimmune disease. We present the case of a 34-year-old woman (group A, RhD+) who was treated with multiple antibiotics after meningioma resection. As her hemoglobin (Hb) decreased significantly from 109 g/L to 52 g/L without obvious bleeding, a blood transfusion was conducted soon after the medication, during which acute hemolysis occurred. An unexpected antibody, anti-M (MNS blood group system), was identified in the patient. It was confirmed that both the recipient and donor were group A, M antigen negative (M−) with CCDee phenotype, and no agglutination reactivity was observed in major crossmatch by testing the specimens before and after transfusion. Meanwhile, the results of the direct antiglobulin test (DAT) changed from negative to positive. Anti-meropenem, a drug-dependent antibody of meropenem, was detected, and hemolysis resolved after cessation. Anti-meropenem may mainly act through an \     

O型孕妇产前IgG血型抗体效价与新生儿溶血病的相关性

目的:探讨O型孕妇产前IgG血型抗体效价与新生儿溶血病(HDN)的相关性。方法:选择2013年1月至2015年12月期间,在我院分娩的夫妻ABO血型不合的O型Rh(D)阳性孕妇432例及新生儿为研究对象,观察孕妇血清IgG抗体效价情况,新生儿HDN发病情况,并分析二者相关性。结果:432例孕妇中血清IgG抗A(B)效价大于或等于1:64的有189例,占43.75%,随IgG抗A(B)效价升高,孕妇比例逐渐减少。随孕次增加,孕妇血清IgG抗A(B)效价逐渐增高,各组孕妇血清IgG抗A(B)效价比较有统计学差异(P0.05)。随年龄增加,孕妇血清IgG抗A(B)效价逐渐增高,各组孕妇血清IgG抗A(B)效价比较有统计学差异(P0.05)。随IgG抗A(B)效价升高,HDN发生率显著升高,各组比较有统计学差异(P0.05)。等级相关检验显示,孕妇血清IgG抗A(B)与HDN发生呈正相关(r=0.732,P0.05)。结论:O型孕妇产前IgG血型抗体是引起HDN的主要原因,其水平与HDN呈正相关,值得临床重视。     

Role of HLA in hematopoietic stem cell transplantation

ABO blood group incompatibility is not a contraindication for allogeneic hematopoietic stem cell transplantation (allo-HSCT). An increasing number of ABO-incompatible HSCT (ABOi-HSCT) procedures have been performed along with advances in donor selection over the years. Currently, whether the recipient-donor ABO incompatibility has detrimental effects on post-HSCT outcomes is a matter of debate. Discrepancies across studies referring to various graft sources, donor types, conditioning regimens, and the use of immunomodulators complicate interpretations of the clinical outcomes of ABOi-HSCT, such as transfusion requirements, graft-versus-host disease (GVHD), disease relapse, overall survival (OS), and non-relapse mortality (NRM). Isohemagglutinins (ISO) targeting red blood cell (RBC) antigens are associated with post-HSCT immunohematological complications, including hemolysis, passenger lymphocyte syndrome (PLS), and pure red cell aplasia (PRCA). Immunohematological events occur frequently and are sometimes difficult to handle in clinical practice. Therefore, it is necessary to form a deeper understanding on the mechanism and a comprehensive management scheme for recipients of ABOi-HSCT. In this review, we summarized literature of the impact of ABO incompatibility on post-HSCT outcomes and outlined important immune-mediated hematological events.     

应用溶血指数探讨溶血对多个生化项目的干扰情况

目的:探讨标本溶血对生化项目检测结果的影响,并使用溶血指数对影响程度进行量化,并探讨其临床意义。方法:总蛋白(TP)、尿酸(UA)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、总胆红素(TBIL)均参考美国临床实验室标准化委员会(CLSI)制定的评价方案EP7-A2文件的标准程序,每个项目收集20份新鲜混合血清(TBIL<17.1μmol/L和TBIL>150μmol/L分别收集),包括参考值范围内的10份、低值和高值各5份,每份新鲜混合血清用3~4份入选血样混合成约8 mL。每份新鲜混合血清分成若干份,分别与洗涤好红细胞配制的溶血液制成5个不同浓度的溶血模型(试验组)及与之配对的无溶血模型(对照组),然后分别测定试验组、对照组及分出的1份混合血清原样的血红蛋白浓度,并在罗氏cobasC501全自动生化分析仪上测定3次所需项目和溶血指数,计算血红蛋白浓度与溶血指数之间的关系,以及溶血对TP、UA、CK、LDH、TBIL检测结果影响的大小。参考EP7-A2文件的统计方法,计算最大允许偏差对应的干扰物浓度,以每份测试混合血清的溶血指数为x轴、其对应的检测项目变化值(干扰值)为y轴绘制干扰曲线。结果:对每项目20份混合血清的660个测试、5个项目3960检测结果用假设检验统计,TP、CK、LDH、TBIL(<17.1μmol/L和>150μmol/L)的μ值分别为4.42、2.34、2.20、2.76、2.93,P值均小于0.05,说明溶血对TP、UA、CK、LDH、TBIL均存在显著干扰。通过回归分析统计出不同溶血程度的溶血指数值对应的干扰变化值的干扰剂量反应曲线。TP、CK、LDH、TBIL的干扰剂量回归方程分别为y=0.0099x-0.065、y=0.1001x-2.42、y=1.1406x-1.3303、y=1.78×10-5x2-0.011x-0.235、y=1.88×10-5x2-0.048x-4.169。从干扰剂量反应曲线可看出溶血对LDH、CK、TP检测产生正干扰,对TBIL检测产生负干扰。同时发现溶血对UA结果的干扰很不稳定,即溶血对尿酸检测结果存在正干扰及负干扰,这一结果得到相关文献印证。结论:溶血指数可作为标本是否合格的客观指标,避免主观判断的误差;利用测得的溶血指数,可从干扰剂量曲线或回归方程求出检测结果的变化值,使临床通过干扰曲线判断溶血对检测项目产生的影响,从而做出准确客观的判断。     

溶血反应对临床生化检验结果的影响分析

目的:研究分析溶血反应对临床生化检测结果的影响。方法:收集我院2015年1月至12月120例正常人体检血液标本资料,采用控制变量法,在试管1中放入正常血液,试管2中放入发生溶血反应血液,分别检测两组血液临床生化指标,并比对变化数据。结果:在检测的17项数据中,血糖、总胆红素、直接胆红素、谷草转氨酶、谷丙转氨酶、碱性磷酸酶、总蛋白、甘油三酯、尿酸、总胆固醇、乳酸脱氢酶等11项数据在试管1与试管2中,检测指标变化大,具有统计学意义(P0.05)。白蛋白、肌酐、尿酸氮、血钙、酸性磷酸酶、血磷等六项指标在试管1与试管2中,含量检测基本无变化(P0.05)。结论:溶血反应的发生对临床生化检测结果影响很大,发生溶血反应会直接影响到酶类等指标的检测结果的准确性,临床检测中应尽量避免溶血反应。     

新生儿ABO 溶血病相关危险因素的临床分析

目的:分析新生儿ABO溶血病的临床相关危险因素,提高对新生儿ABO溶血病的防治水平。方法:选择ABO血型不合的孕妇433例,根据以上产妇产前IgG抗A(B)效价、产妇妊娠次数和产妇年龄分别分组,分析各组产妇间发生新生儿溶血病(HDN)的差异及临床相关性。结果:产妇产前IgG抗A(B)效价、产妇妊娠次数和产妇年龄均与HDN发生率呈正相关性(P<0.05);IgG抗A(B)效价>256时,HDN发生率将显著提高(P<0.01);产妇妊娠次数和年龄增加后,HDN发生率将显著增加(P<0.01)。结论:夫妻血型不合的产妇进行产前保健时,应进行IgG抗A(B)效价检查,当IgG抗A(B)效价>64或IgG抗A(B)效价进行性增加时,应及早做好HDN的干预措施;通过减少意外妊娠及高龄产妇数量,可减少HDN的发生。     

Bilirubinemia and intravascular hemolysis during acclimatization to high altitude

Bilirubinemia has been reported in man and animals exposed to high altitude, but the cause is not well known. Altered conjugation and delayed excretion of the pigment by the liver has been reported to contribute to the high serum bilirubin levels in man and animals exposed to high altitude, but the rate of development of bilirubinemia, the effects of severe polycythemia, altered erythrocyte fragility and intravascular hemolysis have not been thoroughly investigated. A study was made of the serum bilirubin concentration and the extent of intravascular hemolysis in rats during acclimatization to a simulated altitude of 5,500 m. During both continuous and intermittent (4h/d) exposure the serum bilirubin was significantly elevated at the end of 4 to 6 weeks. The elevations occurred only after severe polycythemia developed (hematocrit 68.5%, Hb 21.6 g/100 ml). An increase in intravascular hemolysis was found after 2 weeks intermittent exposure and after 4 weeks continuous exposure to 5,500 m. No change in erythrocyte fragility to account for increased intravascular hemolysis was found in any of the rats exposed continuously or intermittently to high altitude. No liver pathology was observed in rats exposed to 5,500 m. Bilirubinemia in the rat exposed to high altitude may have been due to the greatly increased erythrocyte number (hematocrit above 68%) and to a proportionate increase in destruction of erythrocytes, to increased intravascular hemolysis associated with the increased blood viscosity and possibly to an inability of the liver to handle increased levels of serum bilirubin.Presented at the Seventh International Biometeorological Congres, 17–23 August 1975, College Park, Maryland, U.S.A.     

血型检测用反向定型试剂的研制

将正常的红细胞在特定条件下用甲醛处理,使红细胞膜固定但不影响膜表面糖蛋白血型抗原的活性。采用与正向定型相同的平板凝集试验方法,４０６０份血样正向和反向定型结果完全一致。经稳定性观察９０天,处理后的红细胞与相应抗体的凝集性能未见明显改变。实验结果表明本文介绍的红细胞试剂可用于ＡＢＯ血型鉴定的反向定型试验。     

Molecular analysis to FUT-1, 2, 3 and ABO genotyping may instead of serological typing to diagnose para-Bombay in Chinese

The aim of this study was to evaluate the consistency between serotyping and molecular analysis in Chinese with para-Bombay. The molecular analysis of gene fragments in FUT-1, FUT-2, FUT-3 and ABO genotyping and serotyping were used including a saliva test to examine the A, B, H substance and an absorption elution test to examine the A, B, H; and further routine tests including ABO, H and Lewis phenotype. From eleven samples with anti-H negative, 10 samples were confirmed with para-Bombay by sequencing to FUT-1, from which six samples were 547-548delAG, three samples were 880TT deletion, one sample was 35C>T and one sample was 649G>T heterozygous (h7, China) as carrier. The sequencing to FUT-2 confirmed 357C>T in 11 samples, meaning H, A and B substance was secreted in saliva except for one sample which occurred 385A>T (I129F) heterozygous, which is a weak secretor. The FUT-3 sequence result demonstrated four samples with heterozygous mutations to 59T>G (L20R) combined with 508G>A (G170S) and seven samples without mutations in FUT-3 gene fragment same as reference. The consistency between sequencing with FUT-1/FUT-2 and serotyping by anti-H reported an identical result, except for one sample, which interestingly showed the H/h7 carrier with serotyping negative to anti-H. The result of sequencing with FUT-2/FUT-3 and Lewis phenotyping also reported a complete consistency. The saliva test to A, B, H substance and absorption elution test examining the A, B, H antigens on the surface of red blood cells completely matched the ABO exon 6, 7 sequence results. The sequencing of FUT-1, FUT-2, FUT-3 and ABO exon 6, 7 may become a useful tool to confirm the para-Bombay blood type.     

The Cytokines Responses against Parvovirus B19 in Miscarriage Women and the Susceptibility of their RhD Blood Type to Contract Parvovirus B19 in South of Iraq

Background:Parvovirus B19 (B19) infection is linked with various diseases. Cytokines play critical roles in cellular response to viral infection. It has also been reported that’s susceptibility of the ABO blood type people to several viral infection. In this study, we evaluated interleukin 6 (IL-6), interleukin 8(IL-8), and interferon gamma (IFN-γ) levels in aborted women infected with parvovirus B19 (B19+/Abr+) and uninfected with B19(B19-/Abr+) in comparison with healthy women (B12-/Abr-) and susceptibility of their RhD blood type to contract B19.Methods:B19+/Abr+ were diagnosed using IgM and IgG antibodies against B19, and the concentrations of IL-6, IL-8, and IFN-γ were determined using enzyme-linked immunosorbent assay (ELISA) test in both B19+/Abr+, B19-/Abr+, and B19-/Abr-. Here, we also collected blood groups, number of abortion, and gestational ages from 200 B19+/Abr+ along with the same number ofB19-/Abr+ and B19-/Abr-.Results:The levels of IFN-γ were higher in serum of B19-/Abr+andB19+/Abr+ group in comparison to B19-/Abr-, while the serum levels of IL-6, IL-8were increased in B19+/Abr+ group in comparisontoB19-/Abr+ and B19-/Abr-. Our analyzed data also showed that aborted women with RhD+ are more susceptible to contract s B19 than people with RhD- blood type.Conclusion:B19 infection may differently modulate the amount of cytokines in the plasma of aborted women. So, it can be suggested that IL-6, IL-8, and IFN-γ potentially useful as markers for inflammation intrauterine. The susceptibility/protection of aborted women against B19 might be determined based on RhD blood type.Key Words: Aborted women, IL-6, IL-8, IFN-γ, Parvovirus B19, RhD blood type     

Early predictive value of cord blood bilirubin and dynamic monitoring of transcutaneous bilirubin for hyperbilirubinemia of newborns

ObjectiveTo study the early predictive value of cord blood bilirubin and dynamic monitoring of transcutaneous bilirubin for hyperbilirubinemia of newborns.Methods389 newborns delivered from June 2014 to December 2015 were enrolled as the research subjects; detailed records were made about the general data of newborns and mothers, and after cord blood bilirubin being graded, the incidence of hyperbilirubinemia was counted, and the prediction efficiency of cord blood bilirubin was analyzed by receiver operator characteristic (ROC) curve. At the same time, the transcutaneous bilirubin was detected continuously when the neonate was born and 24 h, 48 h and 72 h after birth, and the relativity between transcutaneous bilirubin at 72 h and serum bilirubin was analyzed.ResultsNo significant difference was found in the hyperbilirubinemia group and the non-hyperbilirubinemia group concerning general data of the newborns and their mothers. With the concentration of cord blood bilirubin increased, the incidence of hyperbilirubinemia also increased; separate prediction of hyperbilirubinemia by cord blood bilirubin showed a sensitivity and specificity of 71.4% and 65.6% respectively, and they need further dynamic monitoring. The daily mean of transcutaneous bilirubin in hyperbilirubinemia group was significantly higher than that in non-hyperbilirubinemia group at 24 h, 48 h and 72 h, and the measurement value of transcutaneous bilirubin at 72 h had a high correlation with serum bilirubin. When transcutaneous bilirubin value is higher than 18, the incidence of hyperbilirubinemia should be considered.ConclusionsThe increase of cord blood bilirubin effectively predict the occurrence of neonatal hyperbilirubinemia. There is a good correlation between levels of transcutaneous bilirubin and serum bilirubin. Moreover, combined detection of transcutaneous bilirubin and cord blood bilirubin can significantly improve the prediction accuracy of hyperbilirubinemia.     

Enfermedad hemolítica del feto y del recién nacido por aloanticuerpos contra el antígeno M

There are few case reports of hemolytic disease in fetuses and newborns (HDFN) caused by alloantibodies against the MNS blood group system. The reason for this dearth is that antibodies toward these antigens are usually IgM, which not only cannot cross the placental circulation but also react at temperatures below 37°C. They are, therefore, of minimal clinical importance. Nevertheless, cases have been reported in which the presence of anti-M IgG antibodies caused severe HDFN and even intrauterine death in the presence of maternal-fetal MNS incompatibility indicating that they could have a high clinical impact. The hemolytic pattern observed in these cases is similar to that caused by anti-Kell antibodies. Progressive anemia is mediated and developed through hematopoietic suppression inducing the destruction of bone marrow precursor cells with the resulting absence of reticulocytes in peripheral blood.This occurred in the case of a woman at 38.5 weeks of gestation who showed a discrepancy between direct and reverse blood type determination. A direct Coombs test was performed on the newborn’s blood, which was positive in the absence of maternal-fetal ABO incompatibility. Further tests were performed and anti-M antibodies were found in the maternal serum screening. Our final diagnosis was largely due to discrepancy issues in maternal blood. Although anti-M antibodies do not usually play a significant role in HDFN, this case stresses the importance of identifying the presence of antibodies that can be crucial in preventing HDFN and lead to new recommendations for the screening and prompt treatment of hemolysis in newborns.     

全自动血型仪的应用评价

目的了解全自动血型鉴定系统用于检测ABO血型和Rh(D)血型的效果。方法采用深圳爱康AK03A型数字血型仪对北海市中心血站2010年5月—2011年12月无偿献血者20702份样本进行ABO血型和Rh(D)血型鉴定,并与手工试管法进行对比验证。结果发现正反定型不一致的有75例,ABO初筛血型错误的36例,Rh(D)阴性的53例。结论全自动血型鉴定系统检测血型快捷、方便、高效,能降低检测人员的工作强度,但判读结果时需要与手工试管法结合进行验证,才能得出正确的结果。     

Which RhD alleles are risk factors stimulating allo- anti-D?

The aim of this study was to identify the specific RhD alleles that are risk factors for stimulating allo-anti-D and develop a precise strategy for blood transfusion. To confirm the D phenotype, red blood cells suspended in saline should react to serological anti-D from three manufacturers. An antibody screen test, a saline phase test and a micro-column test were conducted to identify allo-anti-D and other allo-antibodies. RhD alleles were genotyped by PCR using sequence-specific primers. Seven hundred subjects who were either pregnant or had undergone transfusion were enrolled in our study; however, 28 samples were excluded because their RhD alleles were normal, as revealed by tests using genotyping kits. A total of 498 cases (74.1%) were RhD-null (lacking exons 1–10 of RhD), 336 were DEL RhD 1227A (20.2%), and 38 were RHD-CE (2-9) -D (5.6%). There were 136 cases (20.2%) with allo-anti-D among the 672 cases, with an allo-anti-D prevalence of 126 cases (25.3%) in 498 cases that were RhD-null, followed by 10 cases (26.3%) among 38 cases with RHD-CE (2-9) -D, and none in 366 cases with RhD1227A. RhD genetic polymorphism was observed in RhD-negative individuals. We concluded that RhD-null and partial D are risk factors for alloimmunization to the D antigen and should be transfused with Rh-negative blood. RHD1227A recipients can be transfused with RhD-positive blood. Pregnant women with the d/d and D-CE(2-9)-D alleles require appropriate anti-D prophylaxis and RhD1227A may induce a higher tolerance.     

Iron status in runners of various running specialties.

The blood iron status of 44 male runners of various running specialties (18 sprinters, 13 middle- and 13 long-distance runners) is evaluated by measuring serum ferritin (SF), serum iron (Si), hemoglobin concentration (Hb), hematocrit (Ht), red blood cells content (RBC) and haptoglobin concentration (Hp). The results of these analyses (except Hp) are compared to those obtained in sedentary male subjects (control group) of the same mean age. Mean SF, SI, Hb and Ht measured in athletes are significantly lower than in control group. The remarkably low Hp values obtained in athletes suggests the occurrence of hemolysis. Using unpaired t test, it appears that the blood iron status of these runners does not depend on their running specialty.     

Study of molecular mechanism and antigen expression of CisAB01 blood group

The paper aims to analyze a rare blood sample in Ganzhou City Hospital with CisAB subtype and explore a feasible pattern for blood typing of rare blood type patients, so as to ensure clinical transfusion safety. The routine serological methods were used for ABO forward and reverse blood typing and the fluorescence real-time PCR technique was used for sample genotyping. A human ABO blood group 6-7 exon sequencing kit was used for sequence analysis. The nucleic acid sequence of the sample was compared with reference sequences. The forward typing results demonstrated that the sample was ABw, RhD positive. The sample exhibited 4+ agglutination with anti-H and anti-AB antibodies. Reverse typing by microcolumn gel method showed an AB result, but the serum sample demonstrated weak agglutination with B cell under room temperature, 4 °C and 37 °C in saline when tested with tube method respectively. The serological results matched with the A₂B₃ serotype. The fluorescent real-time PCR genotyping results displayed A/O01. The sequence analysis demonstrated deletion of guanine in 261-position 467C>T (heterozygote) and 803G>T (heterozygote) mutation respectively. The mutation caused the A glycosyltransferase peptide chain to change from proline to leucine (P156L) at 156 and from glutamate to alanine (G268A) at 268. The result demonstrated that the sample's genotype was CisAB01/O01. The mutation of glycosyltransferase coding gene leads to an abnormal serological reaction pattern. Only by combining the results of genetic analysis can we get the true sample blood type and better ensure the safety of clinical blood transfusion.     

ABO血型正反定型及交叉配血实验在外科病人手术输血中应用

目的:探讨ABO血型正反定型及交叉配血实验在外科手术患者输血中的应用效果及影响因素。方法:选取我院自2017年2月-2019年2月收治的80例行ABO正反定型与交叉配血治疗的外科手术患者,记录ABO反定型与交叉配血不合的标本,使用2-Me处理被患者自身冷抗体凝集的红细胞,同时使用微柱凝胶法、凝聚胺法对血型不规则抗体以及特异性进行筛选和鉴定。分析ABO血型反定型不符合以及交叉配血不合的影响因素。结果:对正反定型完全无凝集反应的80例血清标本进行交叉配血实验,其中8例存在凝集反应,配血不合情况;导致外科手术患者输血中ABO血型反定型不符交叉配血不合的主要因素包括自身冷抗体、血型抗原性减弱、血型不规则抗体以及血型抗体效价减弱等。结论:ABO血型正反定型及交叉配血治疗中的患者中,大部分配血一致,少数的交叉配血不合,主要与自身冷抗体、血型抗原性减弱、血型不规则抗体以及血型抗体效价减弱等因素相关。