86例直接抗人球蛋白试验阳性病例分析  

Analysis of 86 cases of positive direct antiglobulin test

作　　者：张静[1] 刘婷婷 李平[1] Zhang Jing;Liu Tingting;Li Ping(Department of Blood Transfusion, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School,Nanjing, Jiangsu, 210008, China)

机构地区：[1]南京大学医学院附属鼓楼医院输血科,江苏南京210008

出　　处：《当代医学》2019年第7期66-69,共4页Contemporary Medicine

摘　　要：目的调查分析直接抗人球蛋白试验(DAT)阳性患者的病种分布特征及不同病种的抗体和补体类型,并探讨DAT阳性的影响因素及临床意义。方法采用经典试管法对608例患者标本进行DAT初步筛查,DAT阳性标本做进一步抗体和补体分型,分析患者临床资料。结果 608例患者标本主要来自风湿免疫科、血液内科、产科及其他内科。其中检出DAT阳性86例,阳性率为14.14%。86例DAT阳性患者的疾病类型主要为系统性红斑狼疮(SLE)占26.74%,自身免疫性溶血性贫血(AIHA)占18.60%,其他血液病占15.11%,干燥综合征占13.95%,新生儿溶血病占5.81%。DAT阳性患者标本分型结果显示,IgG+C3d类型阳性率最高,占61.73%,其次为单独IgG型和单独C3d型,阳性率分别为19.75%和18.52%。结论对DAT阳性结果应结合临床背景进行分析,并进行抗体类型的检定,以辅助临床诊断和治疗。Objective To investigate the distribution of direct antiglobulin test (DAT) positive in hospitalized patients and interpret DAT positive results and its clinical significance. Methods DAT was performed with test tube method by using polyspecific reagents that can simultaneously detect IgG and complement. Subsequently, the positive samples were distinguished by monospecific reagents for specific types of antibodies and complements. Results Total 86 cases were identified as DAT positive in 608 cases (positive rate 14.14%),which mainly from department of rheumatology, hematology, obstetrics and other internal medicine. Among 86 DAT positive cases, patients with systemic lupus erythematosus (SLE) took up the highest proportion of 26.74%, followed by autoimmune hemolytic anemia (AIHA) of 18.60%, other blood disease of 15.11%, Sjogren syndrome of 13.95%, and hemolytic disease of newborn (HDN) of 5.81%. Based on the type of antibody and complement, DAT positive samples were classified as IgG+C3d, accounting for 61.73%, IgG for 19.75%, and C3d for 18.52%. Conclusion DAT results should be best interpreted in the context of clinical situations and further to distinguish types of antibody and complement, which is helpful for clinical diagnosis and therapy.

关 键 词：直接抗人球蛋白试验 不完全抗体 自身免疫 

分 类 号：R446.6[医药卫生—诊断学]