微柱凝胶抗人球蛋白法检测IgG抗体的实验研究与应用

Empirical study and clinical application on IgG antibody detection with microcolumn gel test and antihuman globulin test

目的:探讨微柱凝胶抗人球蛋白法(MGT-AGT)替代Coombs试验检测IgG抗体的敏感性和对临床患者血液标本直接抗人球蛋白试验(DAT)阳性检出率。方法:采用MGT-AGT法对不同浓度的DAT阳性标本或IgG抗D致敏红细胞及IgG游离抗D抗体进行实验比较,并用MGT-AGT法、凝聚胺试验(MPT)和Coombs试验,对81例临床患者的血液标本DAT阳性检出率进行了比较。结果:对于DAT阳性标本或IgG抗D致敏的红细胞的检测,MGT-AGT法在1:128稀释时可以检出,MPT法在1:32稀释时可以检出,Coombs试验在1:32稀释时可以检出。对于IgG游离抗D抗体的检测,MGT-AGT法在1:32稀释时可以检出,MPT法在1:16稀释时可以检出,Coombs试验在1:16稀释时可以检出。对于81例临床患者血液标本DAT阳性的检出率,MGT-AGT法为:免疫性溶血性贫血患者87.8%,新生儿溶血病患者68.2%,系统性红斑狼疮患者55.5%;MPT法分别为75.6%、54.5%和33.3%;Coombs试验分别为78.1%、54.5%和11.1%,MGT-AGT法的敏感性高于MPT法和Coombs试验(P<0.01)。结论:MGT-AGT法检测DAT阳性标本、IgG抗D致敏的红细胞、IgG游离抗D抗体的敏感性和对临床患者血液标本DAT阳性的检出率均高于MPT法和传统的Coombs试验。

Objective:To study the sensitivity of IgG antibody detection with microcolumn gel test and antihuman globulin test(MGT-AGT) instead of Coombs test,and evaluate its detection rate from those indicating positive by direct antiglobulin test(DAT).Method:Different doses of positive specimens with DAT or sensitized erythrocytes from IgG anti D antigen or free antibodies from IgG anti D antigen were detected with MGT-AGT,and 81 positive blood specimens with DAT were detected with MGT-AGT,Manual Polybrene test(MPT) and Coombs test respectively,then the detection rates were compared and analyzed.Result:For positive specimens with DAT or sensitized erythrocytes from IgG anti D antigen,they could be detected successfully with MGT-AGT while the antibody titer >1:128,and >1:32 with MPT and Coombs test respectively.For free antibodies from IgG anti D antigen,they could be detected successfully with MGT-AGT while the antibody titer >1:32,and >1:16 with MPT and Coombs test respectively.For the 81 positive blood specimens with DAT,the detection rate was 87.8% in immune hemolytic anemia patients,68.2% in hemolytic anemia of newborn patients,and 55.5% in SLE patients with MGT-AGT.The results were 75.6%,54.5% and 33.3% in the three kinds of diseases above-mentioned respectively with MPT,and were 78.1%,54.5% and 11.1% respectively with Coombs test.The sensitivity of MGT-AGT was better than both that of MPT and Coombs test,and the differences were significant(P<0.01).Conclusion:MGT-AGT is more sensitive than both MPT and Coombs test when positive specimens with DAT or sensitized erythrocytes from IgG anti D antigen or free antibodies from IgG anti D antigen are detected.