乙型肝炎患者直接抗球蛋白试验临床意义的探讨  

Study on the clinical significance of direct antiglobulin test in patients with chronic hepatitis B

作　　者：李宁[1] 曹微微[1] 李碧娟[1] 刘跃辉[2] 周蓉蓉[2] 刘洪波[2] 范学工[2] 

机构地区：[1]中南大学湘雅医院输血科,湖南长沙410008 [2]中南大学湘雅医院感染病科,湖南长沙410008

出　　处：《中国输血杂志》2008年第9期684-687,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨直接抗球蛋白试验(DAT)在乙型肝炎患者中的临床意义。方法分别应用柱凝集法(CAT)和传统试管法(CTT)对50名慢性HBV感染无症状携带者、42名慢性乙型肝炎(慢乙肝)患者和52名慢性重型肝炎(慢重肝)患者红细胞膜吸附的抗体进行检测。结果慢重肝患者红细胞计数及血红蛋白(Hb)浓度均明显低于慢乙肝、无症状携带者和正常对照者(P<0.01);CAT法、CTT法分别检测正常对照和无症状携带者DAT阳性率均为0;CAT法检测慢乙肝和慢重肝患者DAT阳性率分别为14.3%和84.3%,而CTT法的DAT阳性率分别为9.5%和50%;DAT阳性的慢乙肝和慢重肝患者Hb浓度均明显低于相应DAT阴性患者,随着DAT阳性程度的增加,慢重肝患者红细胞计数和Hb浓度均逐渐降低,DAT阳性程度与Hb浓度呈明显的负相关(r=-0.68,P<0.01)。结论DAT阳性的乙型肝炎患者Hb水平明显降低,表明乙型肝炎患者贫血的产生可能与红细胞抗体的存在有关。Objective To investigate the clinical significance of direct antiglobulin test （DAT） in patients with chrorile hepatitis B. Methods Column agglutination technique （CAT） and conventional tube technique （CTF） were used to detect red blood cell （RBC） antibodies in a total of 162 samples, including 50 cases of asymptomatic carriers, 42 eases of active phases of chronic hepatitis B （ CHB ） patients, 52 cases of severe hepatitis and 18 healthy individuals. Results The RBC count and hemoglobin （ Hb ） in patients with severe hepatitis were significantly lower than those in asymptomatic carriers, CHB patients and healthy individuals （P 〈0. 01 ）. The positive rates of DAT, detected by CAT, in CHB patients and severe hepatitis were 14. 3% and 84. 3% , respectively, while those detected by CTT were 9. 5% and 50.0%, respectively. CHB and severe hepatitis patients with DAT-positive results showed lower Hb levels than DAT-negative patients. The RBC and Hb in the patients with severe hepatitis showed a decreasing trend with the increase of agglutination strengths, suggesting that the Hb was negatively correlated with the agglutination strengths of DAT（ r = - 0. 68, P 〈 0. 001 ）. Conclusion Hb levels were significantly lower in DAT-positive chronic hepatitis B patients, suggesting that the presence of red blood cell antibodies may be associated with the anemia in these patients.

关 键 词：血红蛋白 乙型肝炎 直接抗球蛋白试验 贫血 

分 类 号：R457.1[医药卫生—治疗学] R466.62[医药卫生—临床医学]