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目的分析57例多发性骨髓瘤引起ABO血型鉴定异常的各种原因及解决策略。方法随机用美国ORTHO Auto Vue Innova、美国BIO-RAD IH1000、西班牙GRIFOLS ERYTRA全自动血型仪检测出多发性骨髓瘤引起的ABO血型鉴定异常标本共57例。采用血型鉴定试管法、吸收放散实验、抗体鉴定等多种方法辅助进行ABO血型判断。结果多发性骨髓瘤引起的ABO血型鉴定异常的57例中,抗体减弱引起25例(43.9%);冷抗体干扰引起12例(21.1%);蛋白凝集干扰引起10例(17.4%);抗体丢失引起5例(8.8%);抗原与抗体变异引起3例(5.3%);抗原减弱引起2例(3.5%)。结论多发性骨髓瘤引起ABO血型鉴定异常的主要原因是患者抗体减弱,其次是冷抗体干扰、蛋白凝集干扰、抗体丢失、抗原与抗体变异、抗原减弱等。可以根据多发性骨髓瘤引起ABO血型异常的实验结果及患者病史选择相应的辅助实验进行正确的血型鉴定,保障患者临床输血安全。
Objective To analyze all kinds of causes of ABO blood group abnormalities caused by multiple myeloma in 57 cases and its solutions. Methods A total of 57 ABO blood group abnormalities caused by multiple myeloma were detected randomly by American ORTHO Auto Vue Innova, American BIO-RAD IH1000 and Spanish GRIFOLS ERYTRA automatic blood analyzer. A blood type identification test tube method, absorption and diffusion test, antibody identification and other methods to assist in the ABO blood type judgment. Results Among the 57 cases with ABO abnormalities caused by multiple myeloma, 25 cases (43.9%) were abolished by antibody ablation, 12 cases (21.1%) were caused by cold antibody interference, 10 cases (17.4%) were caused by protein agglutination and the antibody was lost Five cases (8.8%) were caused; three cases (5.3%) were caused by antigen and antibody variation; two cases (3.5%) were caused by reduced antigen. Conclusions The main reason of ABO blood group abnormalities caused by multiple myeloma is the decrease of antibody in patients, followed by the interference of cold antibody, the interference of protein, the loss of antibody, the variation of antigen and antibody and the decrease of antigen. According to multiple myeloma ABO blood group abnormalities caused by the experimental results and patient history select the appropriate auxiliary experiments for the correct blood type identification, to ensure the safety of clinical transfusion patients.