[1]张良子,左琴琴,吴大洲,等.1 例骨髓增生异常综合征多次受血患者血清存在抗-M，抗-cE 和抗-Jkb 抗体的鉴定及配血输血策略[J].现代检验医学杂志,2023,38(01):195-198.[doi:10.3969/j.issn.1671-7414.2023.01.037]
　ZHANG Liang-zi,ZUO Qin-qin,WU Da-zhou,et al.Identification and Transfusion Strategy of Anti-M，Anti-cE and Anti-Jkb Antibodies in the Serum of Patients with Myelodysplastic Syndromes Receiving Multiple Blood Transfusions[J].Journal of Modern Laboratory Medicine,2023,38(01):195-198.[doi:10.3969/j.issn.1671-7414.2023.01.037]
点击复制

1 例骨髓增生异常综合征多次受血患者血清存在抗-M，抗-cE 和抗-Jkb 抗体的鉴定及配血输血策略()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年01期
页码:
195-198
栏目:
检验与临床
出版日期:
2023-01-15

文章信息/Info

Title:
Identification and Transfusion Strategy of Anti-M，Anti-cE and Anti-Jkb Antibodies in the Serum of Patients with Myelodysplastic Syndromes Receiving Multiple Blood Transfusions
文章编号:
1671-7414（2023）01-195-04
作者:
张良子; 左琴琴; 吴大洲; 褚晓月; 毛 娟; 张薇薇; 王 红; 徐 华
（陕西省血液中心，西安 710061）
Author(s):
ZHANG Liang-zi; ZUO Qin-qin; WU Da-zhou; CHU Xiao-yue; MAO Juan ; ZHANG Wei-wei ;  WANG Hong; XU Hua
(Blood Center of Shaanxi Province, Xi’an 710061, China)
关键词:
骨髓增生异常综合征; 抗-M; 抗-Jkb
分类号:
R551.3；R457.12
DOI:
10.3969/j.issn.1671-7414.2023.01.037
文献标志码:
A
摘要:
目的 通过对临床送检的1 例骨髓增生异常综合征（myelodysplastic syndrome, MDS）多次受血患者的抗筛阳性标本进行鉴定，探讨此类复杂不规则抗体的鉴定思路、方法及输血方案。方法 鉴定标本ABO，Rh，MNS 和Kidd 等血型，应用2 种谱细胞及筛选出的无偿献血者细胞配合吸收放散实验进行抗体筛查、复杂不规则抗体特异性鉴定，采用盐水法、凝聚胺法和间接抗球蛋白方法进行交叉配血。结果 患者血型血清学结果为O，CCDee，M-N+ 和Jk(a+b-)，其血清中检出IgM-M，IgG-cE 和IgG-Jkb 抗体，筛选M，c，E 及Jkb 抗原均为阴性的供血者与患者进行交叉配血，配血相合后进行输注。结论 针对多次受血患者产生的复杂不规则抗体，应灵活运用灵敏度高的血清学方法，联合多种谱细胞，准确鉴定出抗体特异性，为临床提供相合的血液，有效保障输血的安全性。
Abstract:
Objective To identify the anti-screening positive specimens of a patient with myelodysplastic syndrome (MDS) who received multiple blood samples, and explore the identification ideas, methods and transfusion schemes of such complex irregular antibodies. Methods Identified the ABO, Rh, MNS and Kidd blood groups, screened and identified the mixed irregular antibodies through absorption and elution test with various cell panels. Cross matching was performed by saline method， polyamine method and indirect antiglobulin method. Results The blood types were O, CCDee, M-N+, Jk(a+b-). IgM-M， IgG-cE and IgG-Jkb antibodies were detected in the serum of patients in control of the cell spectrum response pattern. The blood donors who were negative for M, c, E and Jkb antigens were selected for transfusion after cross matching. Conclusion For the identification of mixed irregular antibodies, should clarify the idea of identification，combine various cell panels, flexibly use of serological methods, effectively improve the ability of laboratory to solve difficult problems，provide compatible blood for clinical，and ensure blood transfusion safety.

参考文献/References:

[1] 卢卫兰, 刘晓娟, 葛守辈. 地西他滨联合HAG 方案治疗骨髓增生异常综合征的临床效果观察[J]. 实用中西医结合临床, 2021, 21(20):76-77.
LU Weilan, LIU Xiaojuan, GE Shoubei. Observation on the clinical effect of dicitabine combined with HAG regimen in the treatment of myelodysplastic syndrome[J]. Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine, 2021, 21(20): 76-77.
[2] 左琴琴, 吴大洲, 毛娟, 等. 特殊自身抗体的鉴定及相关输血分析[J]. 中国输血杂志, 2018, 31(1):64-66.
ZUO Qinqin, WU Dazhou, MAO Juan, et al.Identification of special autoantibodies and analysis of related blood transfusion applications [J]. Chinese Journal of Blood Transfusion, 2018, 31(1):64-66.
[3] MAKROO R N, RAJPUT S, AGARWAL S, et al.Prevalence of irregular red cell antibody in healthy blood donors attending a tertiary care hospital in North India[J]. Asian Journal of Transfusion Science, 2018,12(1): 17-20.
[4] 王侠, 段会强. 输血前不规则抗体筛查降低溶血性输血不良事件的临床效果[J]. 临床医学研究与实践,2020, 5(5):115-117.
WANG Xia, DUAN Huiqiang. Clinical effect of irregular antibody screening before blood transfusion on reducing adverse events of hemolytic transfusion[J].Clinical Research and Practice, 2020, 5(5): 115-117.
[5] 张印则, 徐华, 周华友. 红细胞血型原理与检测策略[M].2 版. 北京: 人民卫生出版社, 2019:93-95.
ZHANG Yinze, XU Hua, ZHOU Huayou. Principle and detection strategy of red blood cell blood group[M]. 2th ed .Beijing: People’s Medical Publishing House, 2019:93-95.
[6] BELINGA S, NGO-SACK F, BILONG C, et al. High prevalence of anti D antibodies among women of child bearing age at Centre Pasteur of Cameroom[J]. Afr J Reprod Health, 2009, 13(3): 47-52.
[7] 彭进, 梁延连, 徐华, 等. 西安地区献血人群MNS血型基因多态性研究[J]. 中国输血杂志, 2017,30(6):590-592.
PENG Jin, LIANG Yanlian, XU Hua, et al. Analysis of genetic polymorphism of blood donors in Xi’an based on the MNS human blood group system[J]. Chinese Journal of Blood Transfusion, 2017, 30(6): 590-592.
[8] 杰夫·丹尼尔斯. 人类血型[M]. 2 版. 朱子严, 译. 北京: 科学出版社, 2007:171-173.
JEFF Daniel. Human Blood Groups[M]. 2th ed. ZHU Ziyan, Translate. Beijing: Science Publishing House,2007:171-173.
[9] EMMANUEL A, TAWFEQ N, MARY G, et al. Anti-M-induced delayed hemolytic transfusion reaction[J].Laboratory Medicine, 2020, 51(4): 426-429.
[10] DANIELS G. Human blood groups[Z]. Oxford:Blackwell Science Ltd , 2013: 96-161.
[11] 范亮峰, 刘曦, 沈伟, 等. 不规则抗体体内消减速率的研究[J]. 中国输血杂志, 2016, 29(11):1229-1231.
FAN Liangfeng, LIU Xi, SHEN Wei, et al. The persistence and evanescence of red cell irregular antibody in vivo[J].Chinese Journal of Blood Transfusion, 2016,29(11):1229-1231
[12] 高娃, 何燕京, 白英哲, 等.2012 ～ 2017 年某三甲医院患者Kidd 血型系统特异性抗体回顾调查[J]. 中国输血杂志,2019,32(7):682-685.
GAO Wa, HE Yanjing, BAI Yingzhe, e t al . Retrospective investigation of specific antibodies against Kidd blood group system in a single hospital patient population, from 2012 to 2017[J]. Chinese Journal of Blood Transfusion,2019,32(7):682-685.
[13] 严凤好, 曾少丽, 曾演强, 等. 广东惠州地区献血者Kidd 血型基因频率分布与输血风险评估[J]. 中国输血杂志, 2018, 31(12):1398-1401.
YAN Fenghao, ZENG Shaoli, ZENG Yanqiang, et al.Frequency distribution of Kidd blood group gene and tansfusion risk assessment of blood donors in Huizhou,Guangdong Province[J]. Chinese Journal of Blood Transfusion, 2018,31(12):1398-1401.
[14] 洪毅, 王华. 20 例非ABO-HDFN 血型血清学分析及临床干预结果比较[J]. 现代检验医学杂志, 2021,36(6):120-123.
HONG Yi, WANG Hua. Comparison of serological analysis and clinical intervention results of 20 non-ABO-HDFN serum types[J]. Journal of Modern Laboratory Medicine2021,36(6):120-123.

相似文献/References:

[1]张宇洋,孙雪静.骨髓穿刺涂片联合骨髓活检切片在骨髓增生异常综合征诊断中的应用[J].现代检验医学杂志,2016,31(02):139.[doi:10.3969/j.issn.1671-7414.2016.02.042]
　ZHANG Yu-yang,SUN Xue-jing.Value of Both Bone Marrow Biopsy and Smear in Diagnosis of Myelodysplastic Syndrome[J].Journal of Modern Laboratory Medicine,2016,31(01):139.[doi:10.3969/j.issn.1671-7414.2016.02.042]
[2]韩秀蕊,杨娣娣,赵 园,等.281例骨髓增生异常综合征患者染色体核型分析及临床意义的研究[J].现代检验医学杂志,2015,30(04):91.[doi:10.3969/j.issn.1671-7414.2015.04.025]
　HAN Xiu-rui,YANG Di-di,ZHAO Yuan,et al.Study on Chromosome Karyotype and Its Clinical Significance in 281 Cases of Myelodysplastic Syndromes[J].Journal of Modern Laboratory Medicine,2015,30(01):91.[doi:10.3969/j.issn.1671-7414.2015.04.025]
[3]聂 群,陈卓诚a,聂李平a,等.自动血细胞分析参数对骨髓增生异常综合征和再生障碍性贫血的鉴别诊断价值[J].现代检验医学杂志,2017,32(05):74.[doi:10.3969/j.issn.1671-7414.2017.05.017]
　NIE Qun,CHEN Zhuo-chenga,NIE Li-pinga,et al.Performance of Automatic Blood Cell Analysis Parameters for Differential Diagnosis of Myelodysplastic Syndromes and Aplastic Anemia[J].Journal of Modern Laboratory Medicine,2017,32(01):74.[doi:10.3969/j.issn.1671-7414.2017.05.017]
[4]唐元艳,张利铭,张江召,等.骨髓增生异常综合征患者染色体异常与细胞形态学的相关性分析[J].现代检验医学杂志,2017,32(06):71.[doi:10.3969/j.issn.1671-7414.2017.06.001]
　TANG Yuan-yan,ZHANG Li-ming,ZHANG Jiang-zhao,et al.Correlation between Chromosomal Abnormality and Cell Morphology with Myelodysplastic Syndrome Patients[J].Journal of Modern Laboratory Medicine,2017,32(01):71.[doi:10.3969/j.issn.1671-7414.2017.06.001]
[5]张冬梅,万顺伦,于丽华.骨髓增生异常综合征患者外周血单个核细胞中OTC4，Gli1 基因的表达及与预后的COX 回归分析[J].现代检验医学杂志,2022,37(06):58.[doi:10.3969/j.issn.1671-7414.2022.06.011]
　ZHANG Dong-mei,WANG Shun-lun,YU Li-hua.Expression of OTC4 and Gli1 Genes in Peripheral Blood Mononuclear Cells of Patients with Myelodysplastic Syndrome and Their Correlation with Prognosis by COX Regression Analysis[J].Journal of Modern Laboratory Medicine,2022,37(01):58.[doi:10.3969/j.issn.1671-7414.2022.06.011]
[6]曲志梅,董 伟,刘艳萍.维奈克拉增强MDS 细胞系对地西他滨化疗敏感性机制的实验研究[J].现代检验医学杂志,2023,38(03):53.[doi:10.3969/j.issn.1671-7414.2023.03.010]
　QU Zhi-mei,DONG Wei,LIU Yan-ping.Experimental Study on the Mechanism of Venetoclax Enhancing the Sensitivity of MDS Cell Lines to Decitabine Chemotherapy[J].Journal of Modern Laboratory Medicine,2023,38(01):53.[doi:10.3969/j.issn.1671-7414.2023.03.010]
[7]徐 娟a,贲海祥a,丁琳琳a,等.白细胞介素-1β 基因（rs16944）单核苷酸多态性与骨髓增生异常综合征易感性及临床特征的相关性研究[J].现代检验医学杂志,2023,38(04):51.[doi:10.3969/j.issn.1671-7414.2023.04.009]
　XU Juana,BEN Haixianga,DING Linlina,et al.Study on the Relationship between Single Nucleotide Polymorphism of Interleukin-1β (rs16944) Gene and Susceptibility and Clinical Characteristics of Myelodysplastic Syndromes[J].Journal of Modern Laboratory Medicine,2023,38(01):51.[doi:10.3969/j.issn.1671-7414.2023.04.009]
[8]杨艳敏,郝秀君,赵志芳,等.骨髓增生异常综合征患者骨髓中ABAT mRNA表达和ABAT甲基化水平对预后预测价值研究[J].现代检验医学杂志,2024,39(06):84.[doi:10.3969/j.issn.1671-7414.2024.06.014]
　YANG Yanmin,HAO Xiujun,ZHAO Zhifang,et al.Prognostic Value of ABAT mRNA Expression and ABAT Methylation Level in Bone Marrow of Patients with Myelodysplastic Syndrome[J].Journal of Modern Laboratory Medicine,2024,39(01):84.[doi:10.3969/j.issn.1671-7414.2024.06.014]

备注/Memo

备注/Memo:
基金项目：西安市科技计划项目（21YXYJ0085）：输血中SGK1+T 细胞通过AKT/mToRα 信号通路诱发继发性哮喘的分子机制研究。
作者简介：张良子（1991-）, 女，硕士，主管药师，研究方向：血型与分子生物学，E-mail：liangzi.z@163.com。
通讯作者：徐华（1971-），男，博士，主任技师，研究方向：输血免疫学，E-mail: drxuhua@163.com。
更新日期/Last Update: 2023-01-15