吸收放散試驗在高效價冷凝集素致ABO血型鑒定不符及交叉配血不合的應用

[摘要] 目的 通過采用吸收放散試驗有效解決高效價冷凝集素導致的ABO血型正反定型不符及交叉配血不合的問題，探討疾病狀態下患者血清中高效價冷凝集素對交叉配血試驗的影響。提出吸收放散試驗是免疫血清學實驗中非常重要的技術手段。方法 ABO血型正反鑒定、自身對照試驗、吸收放散試驗、不規則抗體篩選、交叉配血用直接抗人球蛋白法、聚凝胺法配血。結果 采用吸收放散的方法有效的解決冷凝集素對試驗的干擾， ABO血型正反鑒定相符，自身凝集散開，凝聚胺或抗球蛋白交叉配血，主次側均無凝集。結論 重視高效價冷凝集素對血型鑒定和交叉配血的影響，靈活運用吸收放散法，進行抗體篩查以證實與已知特異性抗體反應的抗原活性物質的存在。區分冷凝集素與特異性抗體在鑒定ABO血和交叉配血中的不同意義，通過應用不同介質：鹽水介質、凝聚胺介質或經典抗球蛋白介質，在不同溫度：室溫、4 ℃、37℃分別進行交叉配血試驗，排除血清中是否有其他不規則抗體；亞型或由于疾病導致的抗原抗體減弱造成凝集使配血不合，通常經37 ℃水浴后冷凝集消失，如經37℃水浴后冷凝集仍然存在，考慮有特異性抗體存在，通常配血不合。

[關鍵詞] 吸收放散試驗；冷凝集素；ABO正反定型；交叉配血

[中圖分類號] R446.6 [文獻標識碼] B [文章編號] 2095-0616（2012）22-118-03

Application of absorption-radiation test in ABO blood group identification discrepancy and clinical cross-matching test out caused by high-titer cold agglutinins.

LI Qing Gulzar LI Zhiqiang

Department of Blood Transfusion，Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine，Urumqi 830002，China

[Abstract] Objective To clarify the effect of clinical cross-matching test that caused by high-titer cold agglutinins which in patients serum，the absorption radiation test could solve the problem ABO blood group and finalize the design discrepancy and cross matching out which caused by high-titer cold agglutinins effectively.Puts forward absorption and irradiation test was very important technical means in immune serology experiment. Methods ABO blood group identification， self-reflection experiment，absorption and irradiation test，Irregular antibody screening， direct antiglobulin test of Coombs，Polybrene method.Results Using absorption method could solve the interference effectively which caused by cold agglutinin，ABO blood group identification positive conform to negative，self agglutination to disperse， primary and secondary side without agglutination in cross-matching text by Polybrene method or antiglobulin test of Coombs. Conclusion Pay attention to the effect which caused by high-titer cold agglutinins on blood type identification and cross-matching text，use absorption and irradiation method flexible for antibody screening，to confirm the presence of a substance which has antigenic activity act with the known specific antibody. Distinguish the different meaning between cold agglutinin and specific antibodies in the identification of ABO blood and blood cross-matching.Through the application of different media：saline，Polybrene medium or classic antiglobulin medium，on different temperature：room temperature，4℃，37℃ doing blood cross-matching test，to exclude whether there are other irregular antibody in serum. Subtype，or as a result of illness causing agglutination antigen antibody weakened the matching， usually after water bath on 37 ℃ cold agglutination disappeared，if remain，maybe there are specific antibodies caused the text unmatching.

[Key words] Absorption and irradiation test；Cold agglutinin；ABO blood group identification；Blood cross-matching

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