WARM试剂在去除温自身抗体检测中的应用

Application of WARM Reagent for Removing Warm Autoantibodies

目的探讨并评价WARM试剂在温自身免疫性溶血性贫血患者输血前检查中的应用。方法选取32例直接抗球蛋白试验(DAT)强阳性的自身免疫性溶血性贫血患者样本,使用WARM试剂、氯喹试剂及热放散3种方法,比较自身抗体吸收及去除的效果。结果使用WARM试剂放散后,87.50%患者DAT凝集强度从3+减弱为1+,81.25%患者血清用放散后的细胞吸收自身血清后,IAT凝集强度从2+减弱为w+;而52.17%患者使用氯喹试剂放散后,DAT凝集强度从3+减弱为1+,39.13%患者血清用放散后的细胞作自身抗体吸收后,IAT凝集强度从2+减弱为w+;另一方面使用热放散方法,21.73%患者DAT凝集强度从3+减弱为1+,17.39%患者血清用放散后的细胞作自身抗体吸收后,IAT凝集强度从3+减弱为1+。结论WARM试剂对于温自身抗体的放散及放散后红细胞对自身抗体的吸收效果,明显优于氯喹试剂和热放散方法。

Objective The safe transfusion of warm autoimmune hemolytic anemia requires an efficient assay to detect alloantibodies underlying autoantibodies. We aim to evaluate the effectiveness of autoantibody adsorption with WARM reagent. Methods 32 patients with autoantibodies were studied, the strength of DAT on these RBCs was graded between 3＋ and 4＋. We compared the efficiency of removing warm-reactive autoantibody by treating the cells with WARM method,subjecting them to 56℃ hot method and treating them with the chloroquine-diphosphate method. Results 87. 50% of DAT-positive cases with WARM-treated were reduced from 3＋/4＋ to 1＋, 81.25% of IAT cases after autoadsorption with WARM-treated RBCs were reduceo from 2＋ to w＋. 52. 17% of DAT-positive cases with chloroquine-diphosphate-treated were reduced from 3＋/4＋ to 1＋, 39.13% of IAT cases after autoadsorption with chloroquine-diphosphate-treated RBCs were reduced from 2＋ to w＋. 21. 73% of DAT-positive cases with hot-treated were reduced from 3＋/4＋ to 1＋, 17. 39% of IAT cases after autoadsorption with hot-treated RBCs were reduced from 2＋ to w＋. Conclusion Reducing the strength of positive DAT and freeing antigen sites for autoadsorpfion are more efficient in the WARM method.