【摘要】 目的 探讨基层医院输血科如何利用现有资源，采用常规血清学方法对罕见意外抗体进行鉴定提供思路。方法 选择本院就诊的1名血型正反定型不一致、抗体初筛阳性、常规配血不合的消化道出血患者为研究对象，采用混合人源O细胞吸收法进行血型鉴定，使用常规10系谱细胞抗体鉴定、凝聚胺法抗体鉴定、2-巯基乙醇(2-ME)试验、盲配、家系调查等方法了解抗体特性。结果 患者血清学试验结果：1)血型为B型、RhD阳性，直接抗人球蛋白试验呈阴性；2)抗体性质为IgM型；3)抗-s、抗-Fy~a、抗-k可能性小，复合抗体不能排除；4)患者血液标本与20名供者的血液标本交叉配血试验主侧不合，与同系3个姐妹的血液标本交叉配血试验主侧均相合。结论 倾向推断患者血浆中含有高频抗原系列抗体，无法鉴定时，可经家系调查寻找到相合血源进行辐照、输注。更多还原

【Abstract】 Objective To explore how to identify rare unexpected antibodies using routine serology methods in blood transfusion department of grassroots hospitals. Methods A patient with gastrointestinal bleeding with inconsistent forward and reverse blood typing, positive antibody screening and incompatible blood matching in our hospital was selected as the research object. Mixed human O cell absorption method was used for blood type identification, and 10-panel reagent red blood cells, manual polybrene test, 2-mercaptoethanol（2-ME） test, blind match and pedigree study were used to explore the antibody characteristics. Results The serological test results of the patient′s serum were as follows: The blood group was type B and RhD positive, and negative for direct antiglobulin test; The antibody was IgM; The likelihood of this antibody being anti-s, anti-Fy^a or anti-k was low, and compound antibodies could not be excluded; The blood of the patient did not match with blood samples of 20 blood donors in the major side, while it matched with all the blood samples of her three sisters. Conclusion When the antibodies of high-prevalence antigen series in plasma cannot be identified, the matched blood may be found tthrough family survey for irradiation and transfusion.更多还原