摘要
目的通过调查分析抗-E引发免疫性溶血性输血反应的原因与特征,为保障临床输血安全提供科学的参考依据。方法选取2023年11月-2024年10月期间于本院发生溶血性输血反应的5例患者作为研究对象,患者ABO/RhD血型、抗体筛查、抗体鉴定及直接抗球蛋白试验均采用微柱凝集法,采用二步酶法和聚乙二醇(PEG)、酸放散技术及毛细管离心法等技术调查患者发生溶血性输血反应的原因。结果5例患者输血前抗体筛查均为阴性,但在输入了表型为E+的红细胞后,患者1、2、3、5发生迟发性溶血性输血反应(delayed hemolytic transfusion reaction,DHTR),患者4发生急性溶血性输血反应(acute hemolytic transfusion reaction,AHTR),对溶血性输血反应发生后的患者血样进行检测,均检出抗-E,其中2例为唯酶抗-E。结论抗-E能够引发血管内和血管外溶血,建议ABO/RhD以及RhE抗原匹配输注,并建立地方性的输血数据库,以此减少抗-E引起的免疫性溶血性输血反应。
Objective To investigate the causes and characteristics of immune hemolytic transfusion reactions(HTRs)triggered by anti-E antibodies,so as to provide a scientific reference for guaranteeing clinical blood transfusion safety.Methods Five patients who experienced HTRs in our hospital from November 2023 to October 2024 were selected as the research subjects.ABO/RhD blood grouping,antibody screening,antibody identification,and the direct antiglobulin test(DAT)were conducted using the column agglutination method.The causes of HTRs in these patients were investigated using multiple techniques such as the two-step enzyme method,polyethylene glycol(PEG),acid elution technique,and capillary centrifugation method.Results All five patients tested negative for antibody screening prior to transfusion.However,after transfusion of E+phenotyped blood,patients 1,2,3,and 5 developed delayed haemolytic transfusion reaction(DHTR),while patient 4 experienced acute haemolytic transfusion reaction(AHTR).Anti-E antibodies were detected in all blood samples from the patients after the hemolytic transfusion reaction,including the enzyme-only anti-E antibody in two cases.Conclusion Anti-E antibody can trigger both intravascular and extravascular hemolysis.It is recommended to conduct ABO/RhD and RhE antigen-matched transfusions and establish a regional blood transfusion database to reduce immune hemolytic transfusion reactions caused by anti-E antibody.
作者
黄华丽
李豪
韦月荣
罗瑞献
黄惠妮
谢慧琼
黎海澜
阳子骥
莫柱宁
HUANG Huali;LI Hao;WEI Yuerong;LUO Ruixian;HUANG Huini;XIE Huiqiong;LI Hailan;YANG Ziji;MO Zhuning(Department of Blood Transfusion,The People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)
出处
《中国输血杂志》
2025年第11期1577-1585,共9页
Chinese Journal of Blood Transfusion
基金
广西自然科学基金项目(2021GXNSFAA196029)。
关键词
抗-E
唯酶抗体
输血反应
RH血型系统
意外抗体
anti-E
enzyme-only antibody
transfusion reaction
Rh blood group
alloantibody
