微孔板木瓜酶法和抗人球蛋白微柱凝胶法联合检测献血者不规则抗体的应用

Application of detecting irregular antibodies of blood donors by microplate papain method and anti-human globulin microcolumn gel technique

目的分析与探讨微孔板木瓜酶法和抗人球蛋白微柱凝胶法联合检测献血者不规则抗体的具体情况。方法将收集到的12293例无偿献血者标本进行微孔板木瓜酶法的抗体筛查,筛查到阳性标本联合抗人球蛋白微柱凝胶法检测,将检测为阳性的标本送输血研究室确认和鉴定,并计算微孔板木瓜酶法和抗人球蛋白微柱凝胶法联合检测的耗时和成本。结果12293例标本中微孔板木瓜酶法筛查到阳性标本140例,阳性率为11.39‰,联合微柱凝胶法检测到6例阳性标本,阳性率为0.49‰。判定为阳性的标本送输血研究室鉴定,IgG型3例(抗-E型1例,未知型抗体2例),IgM型3例(抗-Lea型、抗-Leb型和抗-Lea+Leb型各1例)。标本数为0~88个(一批次)时联合检测耗时为1 h 45 min~1 h 50 min,352个标本(四批次)以内每增加0~88个的标本(一批次)耗时增加约10 min。检测成本约为每个标本0.37元。结论利用微孔板木瓜酶法和微柱凝胶法联合筛查能筛检出常规血型仪检测不出的不规则抗体,且此方法灵敏度高、特异度强、检测耗时短、成本低,适合血站系统对献血者不规则抗体的大规模筛查,值得推广。

Objective To analyze and discuss the experimental situation of the microplate papain method and anti-human globulin microcolumn gel technique for blood donors'irregular antibody screening.Methods Irregular antibodies of the 12293 blood donors collected were detected through the microplate Papain method,then the blood samples that were positive in the microplate papain method were re-detected through the microcolumn gel technique.The blood samples that were positive in the microcolumn gel technique were sent to the laboratory of clinical blood transfusion for confirmation and identification.The time and cost of joint detection in the microplate papain method and anti-human globulin microcolumn gel technique were calculated.Results Among the 12293 cases of irregular antibodies screened by microplate Papain from blood donors,140 cases were positive,with a positive rate of 11.39‰,and six cases of 140 positive cases detected through the microcolumn gel technique were positive,with a positive rate of 0.49‰.The positive samples were sent to the blood transfusion laboratory for identification.There were 3 cases of IgG type(1 case of anti-E type,2 cases of unknown type antibody)and 3 cases of IgM type(1 case of anti-Leatype,anti-Lebtype and anti-Lea+Lebtype).When the number of samples was 0-88(one batch),the joint detection took 1 h 45 min-1 h 50 min.When the number of samples was within 352 samples(four batches),the time of joint detection would be increased by about 10 minutes for each additional 0-88 samples(one batch).Conclusion The microplate papain method and anti-human globulin microcolumn gel technique can detect clinically significant irregular antibodies.The method may be sensitive,specific,rapid and economically feasible,and it may be suitable for mass screening of irregular antibodies of blood donors by blood station system and be worth promoting.