红细胞自身抗体的检测及结果分析

Detection of Autoantibody of Red Blood Cells and Analysis of Detection Result

目的分析红细胞自身抗体阳性患者的临床诊断,探讨红细胞自身抗体的临床意义。方法采用微柱凝胶抗球蛋白试验,筛检和鉴定患者红细胞血型不规则抗体,根据抗体是否凝集其自身红细胞,鉴别同种抗体或自身抗体;对鉴定存在红细胞自身抗体的患者,进行红细胞直接抗球蛋白试验,并分析其临床诊断。结果在46000名检测红细胞血型不规则抗体的患者中,检出23名红细胞自身抗体阳性,其中红细胞直接抗球蛋白试验阳性者13名。在23名红细胞自身抗体阳性者中,临床诊断为自身免疫溶血性疾病6名,系统性红斑狼疮5名,Evans综合征2名,自身免疫性肝炎2名,药物性急性自身免疫溶血性贫血1名,过敏性紫癜性肾炎1名,Ⅰ型糖尿病酮症酸中毒1名,溃疡性结肠炎1名,4名未检出与自身免疫相关。结论红细胞自身抗体可出现于多种自身免疫性疾病或与自身免疫相关疾病患者的血浆中,检测红细胞自身抗体对自身免疫性疾病的诊断及治疗有参考意义。

Objective To analyze the clinical diagnosis of patients positive for autoantibody of red blood cells （RBCs） and explore the significance of autoantibody of RBCs in clinic. Methods Screen the patients with irregular RBC antibodies by Microcolumn Gel Comb test. The antibodies were identified as alloantibody or autoantibody according to the results of auto-erythrocyte agglutination test. The blood samples of patients positive for autoantibody of red blood cells were collected for direct antiglobulin test, and the clinical manifestations as well as basis of laboratory diagnosis of them were analyzed. Results Twenty-three patients positive for autoantibody of RBCs were screened from 46 000 patients with irregular RBC antibodies, of which 13 were positive for direct antiglobulin test. Six of the 23 cases were diagnosed as autoimmune hemolytic disease, 5 as systemic lupus erythematosus, 2 as Evans syndrome, 2 as autoimmune hepatitis, 1 as pharmic acute autoimmune hemolytic anemia, 1 as Henoch-Schonlein purpura, 1 as diabetic Ⅰ ketoacidosis and 1 as colitis. However, no autoimmunization-related factors were found in the rest 4 cases. Conclusion The autoantibody of RBCs may be detected in the plasma of patients with various autoimmune or autoimmunization-related diseases. The detection of autoantibody of RBCs is of reference significance in diagnosis and treatment of autoimmune diseases.