2种方法对红细胞同种抗体的检测能力的比较

Comparative analysis of two methods for detection of red cell alloantibodies

目的探讨微柱凝胶抗球蛋白法与传统的试管抗球蛋白法对红细胞同种抗体的检测能力。方法分别采用微柱凝胶抗球蛋白法与经典的试管抗球蛋白法同时对148例含有红细胞同种抗体的样本进行检测,分析比较2种方法的检测结果。结果微柱凝胶抗球蛋白法对于红细胞同种抗体的检出率为98.0%,试管抗球蛋白法的检出率为81.8%,其中,试管抗球蛋白法对抗-D,-E,-C,-c,-e,-C+e,-E+c,-N,-S,-s,-Dia,-Fya,-Fyb,-Jka,-Jkb,-K,-k,-Lua,-Lub,-Lea,-Leb和-P1抗体均能检出,但对于MNS血型系统抗-M的检出率仅为36.0%,对未知抗体特异性的检出率为56.0%;而微柱凝胶抗球蛋白法对所有样本包含的红细胞同种抗体均能检出,除了Kidd血型系统同种抗体,Kidd系统漏检率为37.5%。结论微柱凝胶抗球蛋白法对于红细胞同种抗体的检出率高于试管抗球蛋白法,但是可能会漏检Kidd血型系统同种抗体。二者各有优劣,建议实验室在使用微柱凝胶抗球蛋白法配血时,若发现不匹配,应结合试管抗球蛋白方法,可以更有效地检出抗体和指导输血。

Objective： To compare the potency of red blood cell alloantibody testing between the microtube column gel antiglobulin test and indirect antiglobulin test （IAT） method. Methods Red blood cell alloantibodies, from 148 cases were examined in parallel by the tube IAT and microcolumn gel antiglobulin test. Results There were 98.0% samples to be detectable with microeolumn gel antiglobuiin method and accuracy was 81.8% to IAT method. The potency of detection of clinically significant alloantibodies varied between the test systems： in tube IAT, all serums （plasmas） of antibody-to -D,-E,-C,-C,-e,-C＋e,-E＋c,-N,-S,-s,-Di^a,-Fy^a,-Fy^b,-Jk^a,-Jk^b,-K,-k,-Lu^a,-Lu^b,-Le^a,-Le^b and -PI were detected. But only 36.0% serums contained anti-M were detected and 56.0% serums contained cold alloantibody were detected. In the mierotube column gel antiglobulin test, all serums of antibody were detected except Kidd system. A rather high number （ 37. 5% ） of antibodies were missed in gel test. Conclusion The potency of gel test was higher than IAT in the detection of al- loantibodies with clinical significance, but alloantibody of Kidd system would be missed in the gel test. A proposal has been that both methods should be performed in routinely to the unmatched blood samples.