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目的了解淋巴细胞白血病患者ABO血型抗原减弱的凝集强度及抗体变化情况,探讨适宜的血型血清学检测方法。方法采用全自动血型分析仪对淋巴细胞白血病患者血标本进行ABO血型、Rh D血型鉴定,对正定型凝集强度小于3+的患者血标本,再采用试管法进行抗原凝集强度检测、吸收放散试验及血清抗体检测。结果在36例ABO血型抗原减弱的淋巴细胞白血病患者中,A抗原减弱者19例(52.8%)、B抗原减弱者14例(38.9%)、AB抗原减弱者3例(8.3%),A抗原减弱者高于B抗原减弱者。血型抗原减弱的凝集强度强凝集者13例(36.1%)、较强凝集者10例(27.8%)、混合外观凝集者8例(22.2%)、不凝集者5例(13.9%)。血清中抗体凝集强度弱于2+(2+~w)5例(13.9%),其中抗A抗体减弱者2例(5.6%),抗B抗体减弱者3例(8.3%)。对患者红细胞进行吸收放散试验,凝集强度由阴性至强凝集增加到较强凝集至极强凝集,检出了与患者血清中抗体相对应的预期血型抗原。结论对血型抗原减弱的淋巴细胞白血病患者采用ABO正反定型、吸收放散试验及血清抗体检测,可正确鉴定ABO血型,确保临床输血安全有效。
Objective To investigate the decreased agglutination intensity and antibody changes of ABO blood group antigen in patients with lymphoblastic leukemia and to explore the appropriate blood group serological test methods. Methods Blood samples of patients with lymphocytic leukemia were identified by ABO blood group and Rh D blood group by automatic blood group analyzer. Blood samples of patients with positive definite agglutination strength less than 3+ were detected by test tube method. Serum antibody test. Results Among the 36 patients with ABO-depleted lymphoblastic leukemia, 19 (52.8%) had A weakened, 14 (38.9%) had B weakened, 3 (8.3%) had AB attenuated and A Weaker than those with B-antigen weaker. 13 cases (36.1%) were strongly aggregated, 10 cases (27.8%) were strong coagulation, 8 cases (22.2%) were mixed agglutination and 5 cases (13.9%) were non-coagulation. Serum antibody agglutination intensity was weaker than 2+ (2 + ~ w) in 5 cases (13.9%), of which 2 cases (5.6%) were anti-A antibody weakened and 3 cases (8.3%) were anti-B antibody weakened. The erythrocytes in patients were absorbed and released, the agglutination intensity increased from negative to strong to strong agglutination to strong agglutination, and the expected blood group antigen corresponding to the antibody in the patient serum was detected. Conclusion ABO positive and negative typing, absorption and emission test and serum antibody test for patients with weakened blood group antigen can identify ABO blood group correctly and ensure clinical transfusion safe and effective.