五种不规则抗体检测方法的比较研究

Comparison of Five Methods for Determination of Irregular Antibodies

比较盐水法、木瓜酶法、凝聚胺法、试管间接抗人球蛋白法、全自动微柱凝胶间接抗人球蛋白法检测受血者血清中不规则抗体的敏感性、特异性。选取解放军总医院门诊及住院输血患者5000例,分别采用盐水法、木瓜酶法、凝聚胺法、试管间接抗人球蛋白法、全自动微柱凝胶抗人球蛋白法对其输血前标本进行抗体筛选,对阳性结果进行抗体鉴定。盐水法未能检出阳性结果;木瓜酶法检出其中的15例,特异率86.7%;试管间接抗人球蛋白法检出了其中的19例,特异率为89.5%;凝聚胺法检出阳性结果18例,特异率100%;全自动微柱凝胶间接抗人球蛋白法检出阳性标本22例,特异率90.9%。说明盐水法不适合不规则抗体检测;木瓜酶法检出率低,具有一定局限性;试管间接抗人球蛋白法需要反复洗涤红细胞,费时较多,不便于开展大规模筛查;凝聚胺法简便、快速,但手工操作,不易标准化;全自动微柱凝胶抗人球蛋白法灵敏度高、重复性好、易于标准化,适于临床输血前大批量抗体筛选。

To compare the specificity and sensitivity of five methods including saline test, papain technique, polybrene test, classical indirect antiglobulin technique（ CIAT）, and automatic microcolumn gel indirect antiglobulin test（AMGIAT） for detection of irregular antibodies. 5 000 samples were detected with five above-mentioned methods for irregular antibodies, respectively. The positive rate was observed and the positive samples of irregular antibodies were examined for antibody specificity. Saline test didn＇t detect any positive results; Papain technique detected 15 positive samples, and the specificity rate was 86.7% ; CIAT examined 19 positive samples, and the specificity rate was 89.5% ;Polybrene test detected 18 positive samples, and the specificity rate was 100% ; AMGIAT examined 22 positive samples, and the specificity rate was 90.9%. It is concluded that saline test isn＇t suitable for detection of irregular antibody. Papain technique has some limitation in determination of irregular antibodies. CIAT is complicated because of long period incubation and multiple wash of red blood cells, polybrene test is the most simple and convenient technique for determination of irregular antibodies, but it isn＇t standardized easily. AMGIAT is the most sensitive method and is standardized easily and is fit for clinical massive samples detection before blood transfusion.