122例直接抗人球蛋白试验阳性病例分析

Analysis of 122 cases of direct antiglobulin test positive

目的了解直接抗人球蛋白试验(direct antiglobulin test,DAT)阳性在临床输血患者中的分布,并分析不同疾病DAT抗体和补体类型。方法采用微柱凝胶抗人球蛋白卡对拟输血患者进行输血前检测,DAT阳性标本BIO-RAD抗体分型卡作抗体及补体类型鉴别。结果 4 724例标本中,筛选出122例DAT阳性患者,阳性率为2.58%。在122例DAT阳性标本中,血液系统疾病占41.8%,其次为新生儿溶血病(hemolytic disease of newborn,HDN)和感染性疾病,分别占14.75%和10.66%。DAT抗体及补体分型鉴定结果显示单纯IgG阳性率最高,占76.22%,其次为IgG/C3d、IgG/IgM/C3d和C3d,阳性率分别为9.84%、4.10%和3.28%。DAT抗体在疾病中的分布以IgG为主,但在自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)及系统性红斑狼疮(systemic lupus erythematosus,SLE)患者中,抗体种类包括IgG、IgA和IgM,补体包括C3d和C3c两种。结论 DAT阳性标本中,血液系统疾病所占比率最大,其抗体类型在临床疾病中以单纯IgG阳性为主,而在SLE和AIHA患者中却含有多种抗体和补体。

This study aimed to investigate the distribution of direct antiglobulin test（DAT） positive in blood transfusion patients, analyze the types of antibody and complement in different diseases. DAT was performed with micro-column gel in blood transfusion patients, and the positive samples were further identified the types ofantibodies and complements with BIO-RAD antibody typing card. The test result showed that total 122 cases wereDAT positive in 4 724 cases（positive rate 2.58%）, and in 122 DAT positive samples, the hematological systemdiseases accounted for 41.78%, followed by HDN and infectious diseases, accounting for 14.75% and 10.66% respectively. In the identification of antibody and complement type, the results showed that the positive rate of IgGwas the highest, accounting for 76.22%, followed by IgG/C3d（9.84%）, IgG/IgM/C3d（4.10%） and C3d（3.28%）. Thedistribution of antibodies in the disease was mainly IgG. However, the antibodies including IgG, IgA and IgM alongwith complements C3c and C3 d were detected in the disease of AIHA and SLE. In conclusion, the blood systemdiseases account for the largest proportion among DAT positive samples, and the antibody type is mainly IgG, but avariety of antibodies and complements exist in AIHA and SLE patients.