目的探讨HIV抗体初筛实验结果与确认实验结果之间的关系,为艾滋病检测提供科学依据。方法选择2006年至2010年8月就诊患者传染病检测HIV抗体初筛结果为阳性的标本,送杭州市疾控中心用蛋白印迹(WB)法确认。结果 308份HIV抗体初筛结果为阳性的标本,经WB法确认阳性为177份,其中初筛实验两种或两种以上阳性标本确认的阳性率为87.6%;一种阳性一种阴性标本确认的阳性率为0%。结论利用两种或两种以上不同原理、不同厂家的试剂检测的HIV抗体结果与WB确认实验的检测结果有很好的相关关系,对个体进行诊断时,为慎重起见,必须经WB法确认,且每个患者都要求两份标本。

目的探讨自体血回输(IOAT)在脑外科手术中的临床效果和应用价值,推广其在各种外科大型手术中的应用。方法选择2003~2009年间脑外科患者120例,术中使用美国Haemonetics Cell Saver 5型血液回收仪对出血进行回收,血液经过过滤、离心、洗涤等处理回输给患者,记录其回收血量和回输血量并进行分析。分别检测术前和回输后1 d患者的凝血功能指标,对比输自体血对患者凝血功能的影响。结果术中共回收血液228 310mL,平均每例回收1 902.6 mL;共回输血液56 056 mL,平均每例回输467.1 mL,经处理后回输给患者,未出现1例输血反应,患者术后1 d未出现凝血功能的显著变化(P>0.05)。结论在脑外科手术中应用自体血回输能明显减少异体血的输注,减少输血反应的发生,节约血液资源。自体血回输后未对患者凝血功能产生影响,一般认为回输血量大于1 200 mL可考虑相应的干预措施。

随着现代医学科学和输血技术的迅猛发展,输血在临床抢救与治疗中仍起着不可替代的作用,它既可提高血容量,又能为受血者补充体内减少的成分,特别是在多发伤、大出血、血液病、各种贫血等患者的抢救和治疗中尤为重要[1～3],但由于人类的血液成分的复杂性和多样性以及现有检测水平的局限性,输血仍有可能使受血者发生多种不良反应以及感染输血性传播疾病的潜在风险[4].

我国各地区丙型肝炎病毒感染状况存在差异.为了解我院就诊患者手术及输血前HCV的感染状况,我们统计了从2001年8月至2003年3月期间共19657份手术及输血前患者血清标本抗-HCV的检测结果,现报道如下.

在临床输血实际中,只要求ABO血型的完全配合,而对RH血型系统一般只作D抗原的检查 ,仅给以D抗原相配合的血.对RH血型系统其他诸因子则不作常规检查,这就容易导致误输R H异型血而引发迟缓性溶血性反应,虽然产生这种反应的机率仅占临床输血的万分之一 [1],但在输血实际中仍不可避免地会产生,笔者在20 a余中曾见有数10例.本文就典型4例因误输RH异型血导致配血困难及产生溶血性反应分析如下.

To understand the signifinance of Coomb's test on the treatment of HBV infection. One hundred and thirty two cases (eighty seven males and fourty five females)were collected. The average age of these patients was 43.2 years old. 15 cases of caute hepatitis, 92 cases of middle chronic hepatitis, 17 chronic emergency hepatitis were included in the study. Coomb's test, ANA and CD 4/CD 8 were detected when the patients were admitted to the hospital and during in hospital. Direct Coomb's tests were positve in the patients with actue severe hepatitis, chronic severe hepatitis and chronic emergency hepatitis (Anti-super IgG,anti-c3,and anti-IgG were 19,19 and 2 cases, respectively),while only one case was found positve in the indirected Coomb's test, 19 cases were found that the ANA were positve and CD 4/CD 8 decreased. All the titer of these indexes were positively correlated with the development of the disease. Coomb's test is helpful for the monitor and treatment of HBV.

Objective To evaluate transfusing of leukocyte depleted blood to severe anemia patients before and after renal transplantation. Methods The efficiency of leukocyte removal filter was observed and the level of panel reactive antibody (PRA) compared.The acute rejection rate and the incidence of cytomegalovirus infection were studied in 53 leukocyte depleted blood transfused patients and in 33 whole blood transfused patients. Results The leukocyte removal rate of the filter reached 98.2%±1.5%.In the leukocyte depleted blood transfused patients,there was no rise of PRA neither the occurrence of acute rejection.Whereas the incidence of cytomegalovirus infection has been similar to those with whole blood transfusion.The whole blood transfused patients had high PRA and the early acute rejection rate reached 29.0% Conclusions The clinical application of leukocyte depleted blood transfusion for severe anemia patients before or after renal transfusion is safe and beneficial.