| 摘要: |
| ［摘要］ 目的 分析静脉输注人血白蛋白（HSA）、静注人免疫球蛋白（IVIG）及兔抗人胸腺细胞免疫球蛋白（ATG）对输血相容性检测的影响。方法 回顾性分析2022年1月至2023年12月解放军总医院第一医学中心输血医学科接收的34例因输注白蛋白制品或免疫球蛋白制品导致交叉配血不合、意外抗体筛查阳性和ABO血型正反定型不符的患者的临床资料。使用微柱凝胶法进行ABO/RhD血型定型试验、意外抗体筛查与鉴定试验、交叉配血试验、直接抗人球蛋白试验（DAT）及酸放散试验。结果 10例输注HSA患者中，5例A型和2例AB型患者红细胞放散液检出IgG类抗-A，1例B型患者红细胞放散液检出IgG类抗-B，1例B型患者反定型B细胞出现凝集现象，1例AB型患者红细胞放散液检出IgG类抗-A和抗-B。18例输注IVIG患者中，8例A型患者红细胞放散液检出IgG类抗-A，5例AB型患者红细胞放散液检出IgG类抗-A，1例AB型患者红细胞放散液检出IgG类抗-A和抗-B，3例A型患者和1例AB型患者反定型A1细胞出现凝集现象。6例输注ATG患者均检出非特异性抗体。结论 患者输注HSA、IVIG或ATG后易出现DAT阳性、意外抗体筛查阳性、ABO血型正反定型不符及交叉配血不合，干扰ABO血型鉴定与交叉配血。 |
| 关键词: 人血白蛋白 静注人免疫球蛋白 兔抗人胸腺细胞免疫球蛋白 输血安全 |
| DOI：10.3969/j.issn.1674-3806.2025.12.09 |
| 分类号:R 457.1 |
| 基金项目: |
|
| Effects of HSA, IVIG and ATG infusions on blood transfusion compatibility testing |
|
TAI Shengfei, CHENG Tingting, XU Binglin, FU Lihui, MA Chunya, YU Yang
|
|
Department of Transfusion Medicine, the First Medical Center, Chinese PLA General Hospital, Beijing 100853, China
|
| Abstract: |
| ［Abstract］ Objective To analyze the effects of intravenous infusions of human serum albumin(HSA), intravenous immunoglobulin(IVIG), and rabbit anti-human thymocyte immunoglobulin(ATG) on blood transfusion compatibility testing. Methods The clinical data of 34 patients whose blood samples were received by Department of Transfusion Medicine, the First Medical Center, Chinese People′s Liberation Army General Hospital from January 2022 to December 2023 due to the infusions of albumin products or immunoglobulin(Ig) products resulting in incompatible cross-matching, positive results of unexpected antibody screening, and ABO blood group discrepancies were retrospectively analyzed. ABO/RhD typing test, unexpected antibody screening and identification, cross-matching test, direct antiglobulin test(DAT) and acid elution test were performed by using microcolumn gel method. Results Among the 10 patients infused with HSA, IgG-type anti-A was detected in the red blood cell(RBC) eluate of 5 patients with type A and 2 patients with type AB, IgG-type anti-B in the RBC eluate of 1 patient with type B, and agglutination phenomenon of B cells in reverse typing occurred in 1 patient with type B, and both IgG-type anti-A and IgG-type anti-B in the RBC eluate of 1 patient with type AB. Among the 18 patients infused with IVIG, IgG-type anti-A was detected in the RBC eluate of 8 patients with type A, IgG-type anti-A in the RBC eluate of 5 patients with type AB, and both IgG-type anti-A and IgG-type anti-B in the RBC eluate of 1 patient with type AB, and agglutination phenomenon of A1 cells in reverse typing occurred in 3 patients with type A and 1 patient with type AB. Non-specific antibodies were detected in 6 patients infused with ATG. Conclusion After infusions of HSA, IVIG or ATG, the patients are prone to develop positive DAT results, positive results of unexpected antibody screening, ABO blood group discrepancies, and incompatible cross-matching, which interfere with ABO blood typing and cross-matching. |
| Key words: Human serum albumin(HSA) Intravenous immunoglobulin(IVIG) Rabbit anti-human thymocyte immunoglobulin(ATG) Transfusion safety |
