微柱凝胶技术用于检测β-内酰胺类药物抗体的研究  

β-lactam antibiotics detection using microcolumn gel technology

作　　者：李晓娜[1] 马程明 陈静[1] 赵军莉 赵怡然 郭萌 潘红娟 梁聚友 邢巧玲 郭晶 李旭桐 LI Xiaona;MA Chengming;CHEN Jing;ZHAO Junli;ZHAO Yiran;GUO Meng;PAN Hongjuan;LIANG Juyou;XING Qiaoling;GUO Jing;LI Xutong(Department of Blood Transfusion,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Langfang Blood Center)

机构地区：[1]河北医科大学第三医院输血科,河北石家庄050051 [2]廊坊市中心血站

出　　处：《中国输血杂志》2021年第12期1296-1299,共4页Chinese Journal of Blood Transfusion

基　　金：河北省医学科学研究课题计划(2020979)。

摘　　要：目的建立微柱凝胶法检测β-内酰胺类药物抗体的方法,评估常用β-内酰胺类药物抗体产生情况及临床意义。方法2019年1月~2019年6月从本院创伤急救中心、关节科、脊柱科、骨肿瘤科等科室随机选择有β-内酰胺类抗生素用药史的446名患者,抽取静脉血4mL/(人)份,采用微柱凝胶法分别做不规则抗体筛查、抗球蛋白检测和药物抗体检测;同时收集患者性别、年龄、疾病、输血史、用药情况等。分析各项检测结果和患者疾病、输血史、用药情况等。结果本组有β-内酰胺类抗生素用药史患者的抗体阳性检出率0.45%(2/446);直接抗球蛋白试验阳性率16.38%(73/446),其中与药物处理红细胞未出现凝集反应标本占64.38%(47/73);特异性药物抗体阳性检出率为4.93%(22/446),药物抗体效价为2~128(8);同时检测出1例自身IgM抗体、1例血型相关抗体和2例非特异性蛋白吸附。有输血史者药物抗体阳性率12.10%(22/124),骨肿瘤患者的药物抗体阳性检出率较高。结论直接抗球蛋白试验有助于β-内酰胺类药物抗体的的检测;抗体筛查阴性结果不能完全排除存在药物抗体;特异性药物抗体的检测可大大提高药物抗体的检出率;有输血史的患者药物抗体检出率远高于没有输血史的患者。Objective To develop an assay to determineβ-lactam antibiotics using microcolumn gels and to study theβ-lactam antibiotics present in the blood of patients and their clinical significances.Methods 446 patients with a history of takingβ-lactam antibiotics from January 2019 to June 2019 were randomly selected from Trauma Emergency Center,Department of Arthrosis,Department of Spine and Department of Bone Oncology of our hospital,and 4 mL(per capita)venous blood was collected.Irregular antibody screening,anti-globulin detection and drug antibody determination were performed by microcolumn gel method.The data of gender,age,disease,blood transfusion history and medication were collected.The test results and clinical data were retrospective analyzed.Results The yielding rate of antibody was 0.45%(2/446)in patients with a history of takingβ-lactam antibiotics.16.38%(73/446)of the samples were positive in direct antiglobulin test,and 64.38%(47/73)of them did not agglutinate with RBCs treated with drugs.The yielding rate of specific antibodies against drug was 4.93%(22/446),and the titer ranged from 2 to 128(8).1 case of auto-IgM antibody,1 case of blood group related antibody and 2 cases of non-specific protein adsorption were detected.The yielding rate of drug antibody in patients with blood transfusion history reached to 12.10%(22/124),so it was also high in patients with bone tumor.Conclusion Direct antiglobulin assay is helpful for the detection ofβ-lactam antibodies.The negative results of antibody screening cannot completely exclude the presence of drug antibodies.The yielding rate of drug antibody can be greatly improved by specific drug antibody detection,and it was higher in transfused patients relative to non-transfused one.

关 键 词：Β-内酰胺类药物 微柱凝胶法 药物抗体 药物性溶血 溶血性贫血 

分 类 号：R446.6[医药卫生—诊断学]