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临床输血与检验

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (6): 749-752.DOI: 10.3969/j.issn.1671-2587.2023.06.006

• 临床输血 • 上一篇    下一篇

静脉输注丙种球蛋白对非新生儿溶血患儿交叉配血的影响

陈旭升, 杨永涛   

  1. 清华大学第一附属医院输血科,北京 100016
  • 收稿日期:2023-10-18 出版日期:2023-12-20 发布日期:2024-01-15
  • 通讯作者: 杨永涛,主要从事围术期临床用血管理方面研究,（E-mail）139111504451@139.com。
  • 作者简介:陈旭升,主要从事ABO疑难血型鉴定与配血、新生儿输血、PRP采集与制备方面研究,（E-mail）526268166@qq.com。

The Effect of Intravenous Immunoglobulin on Cross-match in Non-neonatal Hemolytic Children

CHEN Xusheng, YANG Yongtao   

  1. Department of Blood Transfusion, First Affiliated Hospital of Tsinghua University, Beijing 100016
  • Received:2023-10-18 Online:2023-12-20 Published:2024-01-15

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摘要： 目的 研究非溶血患儿静脉输注丙种球蛋白（intravenous immunoglobulin, IVIG）后对交叉配血的影响,探究最佳输血策略。方法 对2020年1月—2022年12月我科收到的12例抗体筛选阴性、交叉配血不合的非ABO溶血患儿标本进行分析,使用试管法进行血型鉴定,使用微柱凝胶法进行抗体筛查、交叉配血、直接抗人球蛋白试验、游离血浆及放散液中抗-A和抗-B检测。结果 IVIG患儿,6例A型、2例AB型患儿血浆中检测到抗-A,3例B型患儿血浆中检测出抗-B,1例AB型患儿血浆中检测出抗-A和抗-B,所有患儿直接抗人球蛋白试验阳性,且均出现不同程度溶血表现,并与同型悬浮红细胞交叉配血不合、与O型洗涤红细胞配血相合。结论 IVIG会导致部分非ABO溶血患儿出现交叉配血不合、轻微溶血症状,宜选择O型洗涤红细胞输注。

关键词: 静脉注射丙种球蛋白, 溶血性输血反应, 交叉配血不合

Abstract: Objective To study the effect of intravenous immunoglobulin（IVIG）on cross-match in non-hemolytic anemia in children to discuss the best-practice transfusion strategy. Methods A total of 12 non-ABO hemolytic patients with negative antibody screening and cross-match incompatibility from January 2020 to December 2022 were included. Blood type identification was performed by tube test method. Antibody screening, cross-match, direct antiglobulin test (DAT), and anti-A and anti-B detection in free plasma and elution test were performed by microcolumn gel card method. Results After receiving IVIG, anti-A was detected in 6 type A and 2 type AB, anti-B in 3 type B, and anti-A and anti-B in 1 type AB. All patients were DAT positive, and appeared different degrees of hemolysis. Those were cross-match incompatible with same blood type suspended red blood cells, but cross-match compatible with type O washed red blood cells. Conclusion After administration of IVIG, some non-ABO hemolysis children have cross-match incompatibility and mild hemolytic symptoms, so it is advisable to choose O-type washed red blood cell.

Key words: Intravenous immunoglobulin, Hemolytic transfusion reaction, Cross-match incompatibility