血液中同种抗体的固相化筛查及其对临床输血效果的影响

Solid-phase screening of antibodies in blood and its effect on clinical blood transfusion

目的对随机献血者及临床输血患者红细胞、血小板、淋巴细胞与中性粒细胞的抗体进行固相化联合筛查体系。方法将单层混合多人份血细胞分别固定在U型微孔板中,制备出固相化抗体筛查体系。然后对随机献血样本2 150例及临床输血患者输血后样本440例血浆中是否含有相应抗体进行检测,并分析对对输血后效果的影响。结果随机献血者样本中抗体筛出率为:红细胞抗体53例(2.5%),血小板抗体22例(1%),淋巴细胞抗体13例(0.6%),中性粒细胞抗体55例(2.6%);临床输血患者输血后样本中抗体筛出率为:红细胞抗体31例(7%),血小板抗体38例(8.6%),淋巴细胞抗体24例(5.5%),中性粒细胞抗体43例(7.5%),混合抗体(包括同时存在两种或两种以上抗体)115例(26.1%)。223次(22.8%)输血后产生疑似不良反应,其中133例(约60%)检出抗体阳性。结论血细胞抗体固相化筛查体系可应用于临床输血前及输血后抗体检测。固相化检测体系灵敏度高于试管法血清学检测与流式细胞术。抗体的存在对输血效果存在一定的影响。

Objective Detecting antibodies against RBCs, platelets, lymphocytes, and neutrophils by a solid-phase an- tibodies screening system. Methods mono-layer blood cell immobilized in the bottom of U-microplate respectively to prepare the solid-phase antibody screening system. Then detecting the antibodies exist or not in 2 150 random blood donor and 440 transfusion patients＇ samples. Analyze the influence of antibodies against blood ceils to the transfusion effect. Results 53 RBC antibodies, 22 platelet antibodies, 13 lymphocyte antibodies, 55 neutrophil antibodies were detected in random blood donor samples; 31 RBC antibodies, 38 platelet antibodies, 24 lymphocyte antibodies, 43 neutrophil antibodies and 115 mixed （two or more antibodies against RBC, platelets, lymphocytes or neutrophils exist at the same time） were detected in transfusion patients＇ samples after detection. 233 suspected adverse reaction happened after transfusion, which antibodies were detected in 133 samples. Conclusion The antibodies against blood cells solid-phase screening system can applied in pre-and post-transfusion detection. The solid-phase screening method is more sensitivity than serologic tube test and flow cy- tometry. Existing of antibodies influence the transfusion effect.