2018年临床输血学实验-文档资料.ppt
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1、临床输血学实验 Transfusion Medicine (blood transfusion laboratories) 上海市第六人民医院 Shanghai Sixth People Hospital 输血科 Transfusion Department,History Ancient times 敬畏血液-生命的源泉-饮血疗法 The period 1500-1800 治疗精神病 血液有毒 放血疗法-人体血液循环,为输血奠定基础-血液的携氧功能,合理治疗手段 The discovery of blood groups 血型之父-Landsteiner,人类血型的发现,为安全输血提供重要保
2、证。 而且,在遗传学、人类学、法医学、免疫学、部分疾病的发病机制探讨上也具有重要意义。,While blood cell antigens: Red cell antigens HLA antigens Granulocytes-specific antigens Platelets(22),Part one Red blood cell group,目的要求: 掌握ABO血型的鉴定 熟悉Rh血型的鉴定,ABO SYSTEM Principle of procedure,红细胞上具有A抗原者为A型- Red blood cells possess A blood group antigens
3、有B抗原者为B型- Red blood cells possess B blood group antigens A和B抗原都没有者为O型- Red blood cells lack A and B blood group antigens A和B抗原都有者为AB型- Red blood cells possess A and B blood group antigens,Rh SYSTEM,The most complex in the red cells antigen Individuals who possess the D antigen are Rh positive, who l
4、ack it are Rh negative. The D antigen is capable of stimulating production of Anti-D in persons lacking the D antigen. Anti-D is a clinically significant antibody capable of causing RBC destruction and may result in hemolytic disease of the newborn and transfusion reaction.,已发现的抗原40多个。 涉及临床主要是5个抗原:
5、C、c、D、E、e及其相应的特异性抗体。 Four other antigens(C、c、E、e) account for almost all of the Rh-related transfusion problems. They are less antigenic than D, and/or the antibodies are less clinically dangerous. But they can cause the transfusion reaction.,Materials Required,Centrifuge 0.9% saline pipetter reagen
6、ts: The monoclonal antibody(IgM) include Anti-A 、 Anti-B 、 Anti-D 5% Standard RBC-Affirmagen,Methods,Solid phase adherence test Tube test Gel test Manual Semi-automated system Automated system,PROCEDURE,Specimen collection and preparation Red blood cell suspensions(4%RBC) can be prepared using the f
7、ollowing combinations of saline and packed red blood cells: Saline Volume-2ml Packed RBC Volume-100ul 被检者RBC用生理盐水配成2-5%悬液待用 (2ml 0.9% NS +100ul 压积红细胞),TEST PROCEDURE-tube test,正定型: 取小试管三只,分别用记号笔标记后加抗A、抗B、抗D血清各一滴,然后加受检者RBC悬液一滴。 blood grouping Add one drop of Anti-A、Anti-B、Anti-D to three tubes separa
8、tely Add one drop of a 2-5% RBC suspension to three tubes separately,TEST PROCEDURE,反定型: 取小试管三只,分别用记号笔标记后加受检者血清一滴,然后加标准A、B及O型RBC各一滴。 reverse grouping Add one drop of serum/plasma to three tubes separately Add one drop of 5% standard RBC to three tubes separately,将上述混匀后静置数分钟或3000r/m离心15s肉眼判断凝集度。 Shak
9、e gently to mix contents of reaction tubes. Centrifuge six tubes with 3000r/s,15m. Shake gently with 45-60 angles. Evaluate six tubes for agglutination and/or hemolysis upon test completion. Record the reaction strength on the paper.,Evaluate the agglutination strength,Interpretation of results,Grou
10、ping anomalies,Cold auto-antibodies Acquired B Unexpected mixed field reactions Partial or weak D D negative Intrauterine transfusions,RhD negative verification,Reagents: three different Anti-D human (IgG) monoclonal antibody Method Indirect antiglobulin test (IAT) Gene test,Indirect antiglobulin te
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