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目的分析2010年度上海市血液中心发放的全国血型血清学室间质控品返回的错误检测结果的原因。方法采用国际血型参比实验室(iBGRL)建立的国际血型血清学室间评分标准,对参评的65家血站及医院输血科或血库血型实验室的回执评分,并计算各项试验的正确率,寻找错误原因。结果全国血站血型室及部分医院血输的ABO定型(包括亚型)正确率为91.5%[243/345:同参考答案数/参评标本数(60×3+65×3)],RhD定型正确率为100%,抗体筛选的正确率为97.86%(367/375),抗体鉴定的正确率为92.97%(172/189:同参考答案数/需参评标本数),交叉配合试验的正确率为99.20%(1 116/1 125)。结论 1)血站血型实验室和医院输血科对ABO亚型的血清学鉴定存在一定缺陷,特别是针对表达较弱的ABO亚型鉴定尚需改进;2)部分实验室抗体筛选存在漏检或鉴定错误,说明漏检实验室所用的血清方法学应进一步改进,鉴定错误的实验室需要改进单特异性抗体和联合抗体的鉴定以及特异性抗体的反应条件等,要对不同的特异性抗原设定不同的反应温度与介质能够区分,避免造成免疫性输血反应;3)交叉配合试验的错误率提示需要对交叉配合试验的方法学加以改进。
Objective To analyze the causes of the false detection results returned by the Shanghai Blood Center in 2010 for the national blood type serological control laboratory products. Methods The international blood type serology inter-laboratory score established by iBGRL was used to score the return receipts of 65 blood stations and hospital blood transfusion departments or blood bank blood type laboratories, and the correctness of each test was calculated , Looking for the wrong reason. Results The correct rate of ABO typing (including subtype) of blood transfusion room and some hospitals in the whole country was 91.5% [243/345: the same reference answer / the number of participating samples (60 × 3 + 65 × 3)], RhD stereotype The correct rate was 100%, the correct rate of antibody screening was 97.86% (367/375), the correct rate of antibody identification was 92.97% (172/189: the same reference number of answer / number of required samples), the correct rate of cross-matching test 99.20% (1 116/1 125). Conclusions1) Serological identification of ABO subtypes in blood group laboratories and hospital blood transfusion departments has some shortcomings. In particular, the identification of ABO subtypes with weak expression needs to be improved.2) Some laboratories have missed screening or antibody screening Identification error, indicating that the missed seizure laboratory serum methodologies should be further improved, the identification of the wrong laboratory need to improve the identification of monospecific antibodies and the combination of antibodies and specific antibody reaction conditions, etc., to different specific antigen set Different reaction temperatures can be distinguished from the medium to avoid immune transfusion reactions; 3) The error rate of the cross-over test suggests that the methodology of the cross-over test needs to be improved.