外源性干扰物对血吸虫间接血凝试验结果的影响

Study on the impact of exogenous interference factors on schistosomiasis indirect hemagglutination assay

目的了解溶血样本、抗凝剂、血清血脂和胆红素等对血吸虫间接血凝试验（IHA）的影响。方法制备或收集溶血血清、抗凝血血浆、不同浓度血脂及胆红素的血吸虫病阳性和阴性血清,进行IHA检测。结果血清溶血样本血红蛋白〈16g/L对IHA结果无影响;血红蛋白≥16g/L时,抗体效价随血红蛋白浓度升高而下降。不同抗凝剂血浆样本较对照血清均下降1个滴度。甘油三酯浓度在2.0-5.0mmol/L间对IHA结果无影响;在6.0-10.0mmol/L间阴性血清出现假阳性;在11.0mmol/L以上时阳性血清比对照血清出现一个滴度的上升,同时阴性血清出现假阳性结果。血清胆红素浓度小于450μmol/l,对IHA结果无影响。结论在模拟状态下,溶血、高血脂及抗凝样本均对IHA结果产生影响;血清胆红素浓度小于450μmol/L对IHA结果无影响。因此在现场及临床进行IHA检测时应避免使用溶血和有抗凝剂的标本,高血脂标本需要复查结果。

Objective To understand the influence of hemolysis sample, anticoagulants, serum lipids and bilirubin on the indirect hemagglutination assay（IHA） of Schistosoma japonicum. Methods Preparing or collecting hemolytic serum, plasma with different anticoagulants, positive or negative sera of schistosomiasis with different concentrations of lipid and bilirubin, all of the samples were used for IHA test. Results There was no effect on the IHA while the concentration of hemoglobin under 16g/L in the hemolysis sample, but when the concentration of hemoglobin rise to 16g/L, the titer of antibody decreased following with the hemoglobin concentration increased. Compared with the sera of positive control, all the plasma samples with different anticoagulants descend one titer. The positive and negative sera with different concentrations of triglyceride showed different results, while the concentration of triglyceride keep in 2.0 to 5.0mmol/L,there were no effect on the IHA test, but if the concentration keep at 6.0to 10.0mmol/l the negative sera will appear false positive result, while the concentration rise to more than 11.0mmol/l, compared with the control it will increased one titer in the positive sera and the negative sera appear false positive at the same time. When the bilirubin concentration is less than 450μmol/L, it can not affect the IHA. Conclusions Under the state of simulation, the hemolysis sample, high blood lipid and anticoagulant samples could affect the IHA test results, there has no effect when the bilirubin concentration is less than 450μmol/L, so we should avoid using hemolysis and anticoagulant specimens, when the samples with high blood lipid, the results need to be reviewed.