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临床输血与检验

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (1): 54-60.DOI: 10.3969/j.issn.1671-2587.2021.01.014

• 基础研究 • 上一篇    下一篇

人血液经56℃孵育处理后溶血率及血型抗原抗体变化*

范亮峰, 陆琼, 姜跃琴, 王中英, 向东   

  1. 200051 上海市血液中心
  • 收稿日期:2020-09-28 发布日期:2021-02-22
  • 通讯作者: 向东,男,主任技师,主要从事免疫血液学研究,（E-mail）xiangdong@sbc.org.cn。
  • 作者简介:范亮峰（1982-）,男,上海人,主管技师,本科 ,主要从事免疫血液学方面研究,（E-mail）02123774@163.com。
  • 基金资助:
    *本研究受上海市卫生健康委员会青年课题（No.20174Y0200）资助

Changes of Hemolysis Rate,Blood Type Antigens and Antibodies in Human Blood after Incubation at 56℃

FAN Liang-feng, LU Qiong, JIANG Yue-qing, et al   

  1. Shanghai Blood Center, Shanghai 200051
  • Received:2020-09-28 Published:2021-02-22

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摘要： 目的 为降低传染风险,对疑似或确诊新型冠状病毒（SARS-Cov-2）患者血样,部分实验室采用56 ℃孵育30分钟后再进行血型血清学检测,该处理方法对输血前检测的影响未见评估研究。本研究对血液样本经56 ℃孵育后的溶血率、红细胞A、B、D抗原凝集强度及其抗体效价进行评估。方法 从上海地区随机抽取正常献血者A型20例,B型20例,AB型10例,O型20例,均为RhD阳性;ABO亚型7例,D变异型6例,经56 ℃孵育后,检测游离血红蛋白水平,评估溶血率;正定型试验,抗原抗体中和试验,抗体效价试验评价A、B、D抗原凝集强度及抗A,抗B效价变化。结果 经56 ℃孵育处理后,红细胞平均溶血率为1.87%±2.02%;血清学红细胞表面A、B抗原凝集强度均存在减弱现象,正常D阳性个体的D抗原未见减弱,D变异型个体D抗原存在减弱现象;孵育后血清中抗-A、抗-B抗体效价降低。结论 血液样本经56 ℃孵育后,均有较低程度溶血,溶血程度不影响血型血清学实验;A、B抗原与抗-A、抗-B抗体均有减弱,但减弱的程度不足以干扰实验室常规血型正反定型试验;ABO亚型抗原在定型试验中可能受到影响。

关键词: 56℃孵育, 溶血率, ABO抗原, D抗原, 新型冠状病毒

Abstract: Objective In order to reduce the risk of infection, the blood samples of patients suspected or diagnosed with novel coronavirus (SARS-Cov-2) were incubated at 56℃ for 30 minutes before serological blood typing in some laboratories. The influence of this method on pre-transfusion detection has not been systematically evaluated. In this study, we investigated the hemolysis rate, erythrocyte A, B, D antigen agglutination intensity and antibody titer of blood samples after this procedure. Methods The blood samples were randomly collected from blood donors and clinical patients in Shanghai, including 20 cases of type A, 20 cases of type B, 10 cases of type AB, 20 cases of type O (all of them were RHD positive), 7 cases of ABO subtype and 6 cases of D variant. The level of free hemoglobin was measured to evaluate the hemolysis rate. The detection of blood typing, antigen-antibody neutralization and antibody titer was to evaluate the agglutination intensity of A, B and D antigens and the changes of anti-A and anti-B titers. Results After the blood samples were incubated at 56℃, the RBC hemolysis rate was 1.87%±2.02%, and the agglutination intensity of A and B antigens decreased. The D antigens in normal D positive individuals did not decrease, while in D-variant individuals decreased. The titer of anti-A and anti-B antibody in serum decreased. Conclusion It was showed that after blood samples were incubated at 56℃, there was a low degree of hemolysis which did not affect serological blood typing, the agglutination intensity of A and B antigens and anti-A and anti-B antibodies decreased which was not strong enough to affect blood typing tests and only ABO subtype antigens may be affected.

Key words: 56℃ incubation, Hemolysis rate, ABO antigen, RHD antigen, SARS-Cov-2

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