目的：分析Evan′s综合征患者输血前的血清学试验结果，探讨该类患者的输血策略。方法根据患者红细胞直接抗球蛋白分型试验结果，选择热放散或氯喹放散法，将放散后的红细胞进行ABO和Rh血型定型，并与自身血清进行吸收试验。热放散液或吸收处理后的血清进行抗体筛选和鉴定试验。根据抗体鉴定结果选择合适的血液，分别采用盐水法、聚凝胺法、LISS/Coomb′s凝胶卡法进行主侧交叉配血试验；对比患者输血前后的血红蛋白，以判定输血效果。结果患者血型均得到正确定型；检出抗-E2例、抗-S1例，1例抗体特异性未明确；交叉配血结果相合，输血效果理想。结论 Evan′s综合征患者的血清学试验相对复杂，应当综合分析；要重视血液选择策略，避免出现输血反应。

Objective To analyze the Evan′s syndrome patients′ serum tests results ,and discuss the strategy for transfusion .Methods Patients′RBC was dealt with heat elution or chloroquine elution according to the direct an-tiglobulin test results .The RBC was divided equally for two parts after elution test ,one was used to test the ABO and Rh group ,and the other was used to absorpt with autoserum .Irregular antibody was screened and identified with elu-ant or the serum after absorption test .Homotype blood was chosen for cross match blood test in saline ,polybrene and LISS/Coomb′s card .Results All patients′ blood was tested correctly .Antibody-like E was identified in two cases , antibody S was identified in one case ,and one patient′s antibody specificity was not identified .Blood cross match blood test was negative .Conclusion Correct serum tests are complicated for Evan syndrome patient ,and strategy for transfusion should be emphasized to avoid transfusion reaction .

目的：对ABO血型正反定型不一致问题进行血型血清学方法分析，归纳解决方案。方法对ABO正反定型不一致受血者的抗凝标本进行正反定型联合对照试验。通过对唾液中A、B、H血型物质进行测定，表明抗原存在于红细胞上，而红细胞表面的弱抗原经过吸收放散试验证明其存在，受血者ABO血型结合临床诊断予以确认。结果1号、2号为自身溶血性贫血的2例患者；3号为B型含冷型自抗体患者；4号为A× B亚型；5号为肠道革兰阴性菌污染A型血液后产生类B抗原患者；6号为A2亚型含抗-A1患者；7号为体内含有抗-M的患者；8号为多发性骨髓瘤所致的球蛋白紊乱患者4例；9号为白血病抗体减弱患者4例；10号、11号为白血病急性发作期抗原减弱患者4例；12号、13号为2例老年患者；14号、15号为2例新生儿，因出生不满三个月，未形成同种抗体，因此，无需测定唾液A、B、H血型物质以及行吸收放散试验。结论为确保输血安全性及有效性，输血前应对血型正确鉴定。

Objective To identify ABO blood group serological inconsistency analysis method, inductive solution. Methods Sam-ples of ABO positive and negative stereotypes of anticoagulation is not consistent in recipients of positive and negative stereotypes United controlled trial. The salivary A, B, H determination of blood group substances, suggesting that antigen present on red cells, and weak red cell surface antigen by absorption elution test to prove its existence, recipient ABO blood group according to the clinical diagnosis of confirmation.Results 2 cases of No.1, No.2 for autoimmune hemolytic anemia patients; 3 B containing cold type auto antibodies in patients with; 4 A × B subtype; No. 5 for intestinal Gram-negative bacteria pollution type A blood type B antigen from patients;6 were A2 subtype containing anti-A1 patients;7 as the body contains anti-M patients;4 cases of globulin in patients with disorders of multiple myeloma in 8; 9 for leukemia antibody of 4 patients with w

目的：利用ABO疑难血型3步分析法对正反定型不一致时导致的疑难血型进行鉴定和分析，探讨其原因与解决办法。方法：用试管法和微柱凝胶卡法常规检测ABO血型，正反定型不符者进一步做吸收放散试验、唾液血型物质测定、抗体筛选、亚型检测等，并应用ABO疑难血型3步分析法进行分析、鉴定。结果：共检测正反定型不符20例。其中2例属于人为原因操作不规范导致正反定型结果不符，另外18例疑难血型鉴定分析原因主要为：生理因素、自身抗体、不规则抗体、血浆蛋白异常、血液病等影响因素。结论：按照不同的确诊试验分别进行鉴定分析判断，选择正确的辅助方法检测ABO血型，提高血型鉴定的准确性与输血的安全有效性。

Objective:To appraise and analyze the complicated blood type caused by positive and negative stereotypes inconformity using ABO complicated blood type 3-step analysis method so as to explore the reasons and solutions. Methods:Both test tube method and micro column cell-bind method were used for routine determination of ABO blood type. When there is the inconformity of positive or negative stereotypes, it is necessary to do absorption test, saliva blood group substance determination, antibody screening, subtype detection and so on and to further apply ABO complicated blood type 3-step analysis. Results:The number of people with positive and negative stereotypes inconformity was 20, of which two cases were caused by inappropriate operation and the others by physiological factor, autoantibody, irregular antibody, abnormal plasma proteins, blood disease and so on. Conclusion:The appraisal, analysis and judgment were respectively performed based on different diagnosistest and the right help

了解Rh(D)阴性献血者中弱D和Del表型的分布情况。方法:对初筛Rh(D)阴性无亲缘关系献血者采用间接抗球蛋白试验检测弱D型,采用吸收放散法检测Del型。结果:在409例盐水法初筛为Rh(D)阴性无亲缘关系献血者中,检出弱D表型27例,占6.61%,Del表型61例,占14.91%,确证Rh(D)阴性321例,占78.48%。在确证Rh(D)阴性献血者中ccee占49.14%,其次是Ccee,占23.47%;弱D表型中cc Ee占4.16%,其次是Ccee,占1.71%;Del表型中Ccee占10.02%,CCee占1.71%。结论:对初筛Rh(D)阴性的献血者应采用更为敏感的试验确证是否为弱D表型或Del表型。为保障输血安全,弱D表型和Del表型献血者应作Rh D阳性看待,而作为受血者则应视为Rh D阴性。

Objective To investigate the distribution of weak D and Del phenotype in unrelated blood donors with negative Rh (D). Methods Four hundred and nineRhD (-) unrelated donors were screened by the saline agglutination method. Type weak D was detected by the indirect antiglobulin test, and type Del was detected by absorb radiation method. Results In 409 RhD (-) samples, 27 cases (6.61%) of type weak D were checked out, and 61 cases (14.91%) were type Del and 321 cases (78.48%) were corroborate for RhD (-), In the confirmed RhD (-) blood donors, phenotype ccee was most (49.14%), followed by Ccee (23.47%), People with phenotype ccEe accounted for 4.16%in type weak D, followed by Ccee (1.71%). Ccee accounted for 10.02%in type Del, and Ccee accounted for 1.71%. Conclusion RhD (-) donors screened by regular testing should adopt a more sensitive test for verifing type weak D or Del. In order to ensure the security of blood transfusion, people with type weak D and Del should be regarded