流式法检测红细胞膜抗体含量在新生儿ABO溶血病的诊断价值

The application of flow cytometry assay in detecting erythrocyte membrane antibodies in diagnosis of ABO hemolytic disease of newborn

目的用流式细胞仪检测新生儿高胆红素血症患儿红细胞膜的抗体含量并进行计数,以探讨红细胞膜抗体计数对新生儿ABO溶血病的早期诊断价值。方法收集患儿静脉血标本70例,其中51例为临床确诊的新生儿溶血病,19例为临床疑似病例,采用流式细胞仪计数患儿红细胞膜被同种血型抗体致敏后的抗体含量水平。结果 51例临床确诊的新生儿ABO溶血病标本均可检测到红细胞膜被同种血型抗体致敏后的相关抗体,但红细胞膜抗体含量及致敏比例有明显差异;19例临床疑似病例中,9例检测到红细胞膜相关抗体,并与临床最后诊断相符,10例结果阴性,其中6例临床排除ABO溶血所致的高胆红素血症,另4例病因不明。结论流式细胞仪可以直接检测到患儿红细胞被同种血型抗体致敏后的抗体含量,特别是对红细胞膜上结合抗体数量少,卡式法检测阴性、临床又高度怀疑的溶血病患儿有重要的临床诊断价值。

Objective Flow cytometry（FCM） assay is used to detect erythrocyte membrane antibodies in hyperbilirnbinemia newborns, and to evaluate the application of this method in diagnosis of ABO hemolytic disease of newborn. Methods A total of 70 cases of blood specimens were collected, including 51 cases with hemolytic disease and 19 cases of suspected specimens. FCM was used to detect the antibodies on the membrane of erythrocytes which were sensitized. Results Associated antibodies were detected in the 51 diagnosis cases, although the percentage of sensitized erythrocytes and the quantities of antibodies on the erythrocyte membrane were greatly varied. In the 19 cases of suspected specimens, antibodies were detected in 9 cases that were consistent with the diagnosis of hemolytic diseases. And the other 10 cases presented negative result, including 6 cases excluded hemolytic disease and 4 cases unknown. Conclusions FCM can be used to detect the quantities of antibodies on the erythrocyte membranes which were sensitized by the same blood grouping antibody. So this assay is of great significance for those whose Coombs tests were negative but hemolytic diseases were highly suspected.