微柱凝胶法与凝聚胺法在临床交叉配血中的比较

Comparison of Microcolumn Gel Method and Polyamine Method in Clinical Cross Matching

目的探讨临床交叉配血中,微柱凝胶法和凝聚胺法的应用效果。方法选取沈阳市骨科医院承基医院于2016年2月至2019年3月192例初次进行输血不规则抗体测定者作为研究对象,应用微柱凝胶法(microcolumn gel test,MGT)和凝聚胺法(manual polybrene test,MPT)对需要输血的192例维持性血液透析患者进行交叉配血研究,将两种配血方法与结果进行对比。结果MPT中8例主侧凝集患者和26例次凝集中均测定出不完全抗体,12例主次测均呈现为凝集状态,124例次MGT次凝集患者,红细胞直接抗人球蛋白测定全部呈现为阳性。8例主侧凝集患者均测定出不完全抗体,经过配型后行O型洗涤红细胞悬液输注,26例MPT次侧凝集患者改为输入同型洗涤红细胞,12例冷凝级和其余90例MPT配血联合患者输入用RBC悬液,30日后随访输血未存在不良反应。本次研究中输血次数为1~、6~、11~、15~、20~,例次分别为384、186、154、130、70,共计924例次;不规则抗体阳性分别为18例(4.69%)、20例(10.75%)、26例(16.88%)、30例(23.08%)、30例(42.86%),共计124例(13.42%);MGT测定总阳性率高于MPT,MGT和MPT配血不相合,组间差异有统计学意义(P<0.05)。MPT平均检测时间(11.51±2.31)min,显著少于MGT平均检测时间(29.63±3.63)min,组间差异有统计学意义(P<0.05)。结论对于维持性血液透析患者,为其输血后呈现出抗体的不规则性。MPT的配血速度快,但是检出率低;MGT阳性检出率高,但是配血时间长,敏感度较高。在MGT中致敏细胞会造成配血难度提升,联合MPT能够进一步提升输血的安全程度。

Objective To explore the application effect of microcolumn gel method and polyamine method in clinical cross matching.Methods From February 2016 to March 2019,192 patients who underwent irregular antibody detection in blood transfusion for the first time in Chengji Hospital of Shenyang Orthopaedic Hospital were selected as research subjects.Microcolumn gel test(MGT)and manual Polybrene test(MPT)were used,conducted a cross-matching study on 192 maintenance hemodialysis patients who needed blood transfusion,and the results of the two blood matching methods were compared.Results In the 8 cases of primary agglutination and 26 times of agglutination,the incomplete antibodies were detected in 12 patients.The main and secondary tests showed agglutination,and 124 patients received secondary microcolumn gel agglutination.Incomplete antibodies were detected in 8 patients with main side agglutination.After matching,O-type washing red blood cell suspension was infused.26 patients with secondary side agglutination by coacervation method were transfused with the same type washing red blood cells.12 patients with condensation level and the other 90 patients with coacervation by coacervation method were transfused with RBC suspension.There was no adverse reaction in the follow-up transfusion 30 days later.The number of blood transfusions in this study was 1-,6-,11-,15-and 20-.The cases were 384,186,154,130,70 respectively,924 times in total,irregular antibody positive in 18 cases(4.69%),20 cases(10.75%),26 cases(26 cases),26 cases(cases),and cases(cases),total cases were positive.There was a statistically significant difference between the two groups(P<0.05).The average detection time of polyamine method(11.51±2.31)minutes was significantly lower than that of microcolumn gel method(29.63±3.63)minutes,and there was a statistically significant difference between the two groups(P<0.05).Conclusion For patients on maintenance hemodialysis,irregular antibodies appear after transfusion.The method of polyamine matched blood fast,but the detection rate is low.Microgel method has high positive detection rate and sensitivity,but it takes a long time to match blood.The sensitization of cells in the microcolumn gel method will increase the difficulty of blood matching,and the combination of the microcolumn gel method and the coagulation amine method can further improve the safety of blood transfusion.