存在自身免疫抗体的患者血型血清学鉴定与输血策略探讨

Discussion on Blood Group Serological Identification and Transfusion Strategies for Patients with Autoimmune Antibodies

摘要: 目的：对存在自身抗体的患者致ABO血型正反定型不符进行检测分析，为自身免疫性疾病患者的疑难血型鉴定及紧急输血提供借鉴。方法：以本实验室2024年12月检出的2例自身免疫性疾病患者为研究对象，采用盐水试管法、微柱凝集法、凝聚胺法、抗球蛋白法等进行输血相容性检测，给予针对性的输血策略，并通过对比输血前后Hb的变化来评价输血疗效。结果：造成血型鉴定困难的主要原因是自身免疫性疾病患者存在非特异性抗体干扰血型鉴定，通过温盐水洗涤、异体吸收法排除干扰，选择ABO和Rh血型相匹配的血液进行输注，输血治疗效果显著。结论：自身免疫性疾病患者可选择ABO和Rh表型匹配输血，提高输血治疗效果。

Abstract: Objective: To detect and analyze the inconsistency of the ABO blood group caused by patients with autoantibodies, so as to provide a reference for the identification of difficult blood groups and emergency blood transfusion in patients with autoimmune diseases. Methods: Two patients with autoimmune diseases detected in our laboratory in December 2024 were used as the research objects, and the transfusion compatibility was tested by saline test tube method, microcolumn agglutination method, condensate method, antiglobulin method, etc, and targeted blood transfusion strategies were given, and the transfusion efficacy was evaluated by comparing the changes of Hb before and after transfusion. Result: The main reason for the difficulty in blood type identification is that patients with autoimmune diseases have non-specific antibodies that interfere with blood type identification. By washing with warm salt water and using allogeneic absorption methods to eliminate the interference, and selecting blood with matching ABO and Rh blood types for infusion, the therapeutic effect of blood transfusion is remarkable. Conclusion: Patients with autoimmune diseases can choose blood transfusion with ABO and Rh phenotypic matching to improve the therapeutic effect of blood transfusion.