凝胶直接抗球蛋白试验在自身免疫性溶血性贫血实验诊断中的应用

The Application of Microcolumn Coomb's Test in the Diagnosis of Autoimmune Hemolytic Anemia

目的探讨凝胶直接抗球蛋白试验的特点及其在自身免疫性溶血性贫血(AIHA)实验诊断中的应用价值,提高致敏红细胞检出率。方法检测临床诊断疑似AIHA标本135例。用Coomb's凝胶试剂卡对受检标本进行直接抗球蛋白试验。以试管法直接抗球蛋白试验作对照。凝胶法阳性者用单特异性IgG和C3d凝胶试剂卡进行分型。结果试管法直接抗球蛋白试验阳性19例,Coomb's凝胶直接抗球蛋白试验(GDAT)阳性24例,两种检测方法间差异有统计学意义(P<0.05)。对24份凝胶直接抗球蛋白试验阳性标本进行IgG和C3d分型,其中IgG+C3d型7例(29%),IgG型13例(54%),C3d型4例(17%)。结论凝胶直接抗球蛋白试验不需洗涤红细胞,操作简便,重复性好;检测致敏红细胞灵敏度优于试管法,在AIHA实验诊断中值得临床推广应用。

Objective To investigate the characteristic of the microcolumn Coomb＇s test and to observe its diagnosis significance in autoimmune hemolytic anemia （AIHA）. Methods Competitive microcolumn gel and a routinely used direct antiglobulin test （DAT） were used to study IgG and C3d in 135 cases of AIHA. Results 19 cases were identified in positive by routine typing. 24 cases were identified in positive by microcolumn gel, ineuding 13 cases in IgG positive, 4 cases in C3d positive and 7 cases both in IgG and C3d positive. There were statistically difference between the microcolumn gel and routine DAT. Conclusion Microcolumn Coomb＇s test is a sensitive and objective method for the diagnosis of AIHA.