1名Am亚型患者的血型血清学鉴定及输血策略

目的对Am亚型患者的血型进行血清学鉴定,并为其输血选择适合的血液成分。方法对1名ABO正反定型不相符患者,用抗-A、抗-A1、抗-B、抗-AB和抗-H单抗检测红细胞ABH抗原;A、B、O型红细胞与血浆反应检测ABO血型抗体及不规则抗体;吸收放散试验检测红细胞弱抗原;中和抑制试验检测唾液中ABH血型物质。根据患者血型血清学检测结果,选择相容血液成分进行输血。结果该患者符合Am亚型的血型血清学特征,输入O型少白细胞红细胞6U,A型单采血小板1治疗量后,均能达到预期疗效,无不良反应。输血后3个月的血型血清学检测结果与输血前完全一致。结论ABO血型鉴定时坚持正、反定型,可避免将Am亚型误定为O型,对Am亚型的准确鉴定有赖于多种血型血清学试验。Am亚型患者输血时可选择O型红细胞、A型血小板、A型或AB型血浆。

Serological Identification and Transfusion Strategy of A Patients of Am Subgroup

Objective To perform serological identification on the blood group of a patients of Am subgroup and selet the blood components suitable for transfusion.Methods A patient with inconsistent results of forward and reverse ABO grouping was determined for erythrocyte ABH antigen by anti-A,anti-A1,anti-B,anti-AB and anti-H McAbs,for ABO blood group antibody and irregular antibody by the reaction of plasma with erythrocytes of groups A,B and O,for weak antigen against erythrocyte by absorption-elution test,for ABH blood group substances in saliva by neutralizing test.Select the blood components suitable for transfusion to the patients according to the dertermination results.Results The patient was of blood group serological characters of Am subgroup.The transfusion of 6 U of leukocyte-poor erythrocytes group O and one therapeutic dosage of platelet group A showed the expected curative effect but no adverse reaction.The results of serological identification 3 months after transfusion were completely consistent with those before transfusion.Conclusion The mis-identification of Am subgroup as O group may be avoided by performing both forward and reverse ABO grouping tests.The correct identification of Am subgroup was based on various blood group serological tests.Erythrocytes group O,platelet group A and plasma A or AB were suitable for transfusion to the patients of subgroup Am.