一型流式细胞仪在胎母免疫诊断中的应用  

The application of fetomaternal immunodiagnostic by flow cytometer

作　　者：聂晓绚[1] 向东[1] 

机构地区：[1]上海市血液中心,上海200051

出　　处：《中国输血杂志》2014年第11期1129-1131,共3页Chinese Journal of Blood Transfusion

摘　　要：目的用流式细胞术测定母亲外周血中胎儿红细胞的血型及含量,可以监控胎母免疫的发生和发展,帮助临床预判新生儿溶血病的发生及严重性。方法以戊二醛作为红细胞表面固定剂,加入FITC标记的胎儿血红蛋白抗体(Hb F),用流式细胞仪检测胎儿红细胞。建立模拟孕妇外周血的试验方法作为对照,估计母血中的胎儿红细胞的含量。结果采用含有1‰胎儿细胞的混合血10例,经试验证明,含1‰阳性细胞的分辨可信度为96.23%,含0.2‰阳性细胞的分辨可信度为45.7%,故流式方法检测Hb F的灵敏度可以达到1‰。实测孕妇血液标本65例,孕妇外周血中Hb F含量x珋=0.002 39,s=0.001 077(t≥0.05,P≤0.05)。选取其中18例中早期孕周血样x珋=0.002 79,s=0.001 023(t≥0.05,P≤0.05)。结论利用流式方法检测胎儿血红蛋白,可以检测孕妇外周血中胎儿红细胞的含量,速度快,特异性好,准确率高,结果稳定可重复,并能对孕周早期预判新生儿溶血症提供帮助。Objective To detect the types and amount of cells contained in the maternal blood using flow cytometry,to monitor the occurrence and development of fetomaternal immunity,and to provide assistance to clinicians on predicting the incidence and the extent of hemolytic disease of newborn. Methods Using prefixation solution（ 0. 05% Glutaraldehyde） as surface fixative with fetal hemoglobin antibody（ Hb F） as an indicator,fetal red blood cells were detected by flow cytometry.Synthetic blood of pregnant woman was established as control,in order to estimate the amount of fetal red blood cells in maternal blood. Results Ten blood samples containing 1‰ fetal red cells were tested. The degree of resolution credibility that 1%in the samples were tested positive achieved 96. 23%; the degree of resolution credibility ofthat 0. 2% in the samples were tested positive was 45. 7%. The results suggested that the sensitivity of Hb F couldreach 1‰. Among 65 pregnant women,the amount of Hb F in their blood was x = 0. 002 39,S = 0. 001 077（ t≥t0. 05,P≤0. 05）. Eighteen samples indicating early weeks of gestation were chosen,the amount of Hb F in their blood wasx = 0. 002 79,S = 0. 001 023（ t≥0. 05,P≤0. 05）.Conclusion Using flow cytometry could help to detect fetal hemoglobin and to detect fetal red blood cells in maternal blood.This test was quick and objective. In addition,it had a high rate of accuracy. The result was consistent and repeatable. This method could also help detect fetomaternal hemorrhage at the early stage of gestation.

关 键 词：新生儿溶血病 流式细胞仪 胎儿血红蛋白(HbF) 模拟孕妇外周血试验 

分 类 号：R722.18[医药卫生—儿科] R446.6[医药卫生—临床医学]