自制增强剂在间接抗球蛋白试验中的临床应用

Evaluation of modified IAT with twoself-made low ionic-strength solutions

目的探索低离子强度盐溶液-聚乙二醇(LISS-PEG)、低离子强度盐溶液-牛血清白蛋白(LISS-BSA)这2种自制增强剂在间接抗球蛋白试验(IAT)中的临床应用。方法将较常见的标准红细胞IgG不规则抗体(抗-D、抗-M、抗-N、抗-S、抗-s、抗-Jk^(a)、抗-Jk^(b)、抗-Fy^(a)、抗-Fy^(b)、抗-Di^(a)、抗-K)与对应抗原的红细胞反应,在反应中分别添加LISS-PEG、LISS-BSA增强剂,选择5 min和15 min 2种不同的孵育时间进行试管法间接抗球蛋白增强试验,与常规IAT作比较。选择100例血液标本中含红细胞IgG不规则抗体的患者,将同样的反应条件应用于患者标本的IAT试验,观察自制增强剂的效果。用AABB评分法记录其凝集强度。结果 LISS-PEG孵育5 min与孵育15 min应用于临床标本IAT凝集强度分值(8.65±0.58 vs 8.7±0.68)比较无差异(P>0.05);LISS-BSA孵育5 min与孵育15 min、常规IAT应用于临床IAT凝集强度分值(5.12±0.34 vs 5.03±0.29 vs 4.78±0.68)比较无差异(P>0.05);LISS-PEG孵育5 min与常规IAT凝集强度分值(8.65±0.58 vs 4.78±0.68)比较有差异(P<0.05)。结论自制的LISS-PEG增强剂应用于IAT中,抗原抗体孵育时间仅需5 min,凝集强度即可达到明显的增强效果,此方法为救治急诊输血患者缩短了交叉配血时间,值得推广使用。

Objective To explore the clinical applications of low ionic strength salt solution polyethylene glycol(LISS-PEG) and low ionic strength salt solution bovine serum albumin(LISS-BSA) in the indirect antiglobulin test(IAT). Methods The common standard red blood cell(RBC) IgG irregular antibodies(anti-D, anti-M, anti-N, anti-S, anti-s, anti-Jk^(a), anti-Jk^(b), anti-Fy^(a), anti-Fy^(a), anti-Di^(b), anti-K) were reacted with RBCs with corresponding antigens in IAT with LISS-PEG and LISS-BSA modification for 5-minute and 10-minute incubations, and then compared the results with conventional IAT. One hundred of blood samples from patients presenting irregular antibodies of erythrocyte IgG were selected to observe the effect of these two self-made modification. The agglutination intensity was recorded by AABB scoring method. Results No difference was noticed in IAT intensity reaction between LISS-PEG 5-minute and 15-minute incubation(P>0.05), nor between 5-minute/15-minute LISS-BSA incubation and conventional IAT(P>0.05).However, LISS-PEG modification demonstrated a significant superiority over the conventional technique just after incubation with 5 minutes(P<0.05). Conclusion Using the self-made LISS-PEG as the enhancement medium allows not only reduced incubation time(5 minutes) but also increased intensity of the reaction, which shortens the cross-matching time for emergency blood transfusion and is worthy of popularization.