标题：一例抗-Lex不规则抗体的鉴定分析及临床意义

      作者：郑显良，姚中吉，杨达刚    海南医学院第二附属医院输血科，海南 海口 570311

      卷次： 2019年30卷8期

      【摘要】 目的 探讨抗-Lex对输血相容性检测的影响。方法 ABO血型、Lewis血型检测采用试管法；阳性标本抗体鉴定采用试管法盐水介质、IAT和凝聚胺试验。结果 患者血清在盐水介质中与Le(a+b-)、Le(a-b+)谱细胞均发生凝集，并在 4℃增强；经 2-Me处理后与Le(a+b-)、Le(a-b+)的细胞在盐水、抗人球介质中均不凝集,表明抗-Lex为 IgM抗体；该抗体在37℃与表型Le(a+b-)的红细胞反应可激活补体。结论 盐水法和包含抗-C3d的多克隆抗球蛋白试验同时进行抗体筛查，可避免Lewis抗体漏检，保证用血安全。
      【关键词】 输血；抗-Lea；抗-Leb；抗-Lex；疑难配血
      【中图分类号】 R446.11 【文献标识码】 A 【文章编号】 1003—6350（2019）08—1042—03

Identification and clinical significance of an anti-Lex in one case.
ZHENG Xian-liang, YAO Zhong-ji, YANG Da-gang.Department of transfusion, the Second Affiliated Hospital of Hainan Medical College, Haikou 570311, Hainan, CHINA
【Abstract】 Objective To investigate the effect of anti-Lex on blood transfusion compatibility test.Methods ABO blood group and Lewis blood group were detected by test tube method. The antibody identification ofpositive samples was conducted by test tube test with saline medium, indirect anti-globulin test (IAT), and polyaminetest. Results Patients' serum agglutinated with Le(a + b-) and Le(a-b + ) spectrum cells in saline medium, and enhancementwas found at 4℃. After 2-Me treatment, the cells with Le(a+b-) and Le(a-b+) did not agglutinate in saline and antihuman glob-ulin medium, indicating that anti-Lex was an IgM antibody. The antibodies can react with the red blood cells of the phe-notype Le(a+b-) to activate the complement at 37℃. Conclusion The brine method and the polyclonal anti-globulin testcontaining anti-c3d were simultaneously screened for antibodies to avoid the leak detection of Lewis antibodies and en-sure the safety of blood use.
      【Key words】 Blood transfusion; Anti-Lea; Anti-Leb; Anti-Lex; Difficulty in matching blood·短篇论著·doi:10.3969/j.issn.1003-6350.2019.08.026