流式细胞术检测孕妇外周血中胎儿红细胞的应用价值  

Application value of flow cytometry in the detection of fetal red blood cells in maternal peripheral blood

作　　者：崔瑾[1] 詹茜[1] 罗琴[1] 李俊男[2] 张玉洪[1] CUI Jin;ZHAN Qian;LUO Qin;LI Junnan;ZHANG Yuhong(Center for Clinical Molecular Medical Detection,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Obstetrics,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院临床分子医学检测中心,重庆400016 [2]重庆医科大学附属第一医院产科,重庆400016

出　　处：《检验医学与临床》2022年第14期1873-1877,1881,共6页Laboratory Medicine and Clinic

基　　金：国家自然科学基金项目(81873972)。

摘　　要：目的探讨流式细胞术和血红蛋白电泳联合检测诊断胎母输血综合征的价值。方法采用抗胎儿血红蛋白(HbF)单克隆荧光抗体滴度试验找出流式细胞术检测时抗HbF单克隆荧光抗体与胎儿红细胞数量的最佳反应比,再对该方法的准确度、灵敏度、特异度及重复性进行评价,最后对临床疑似发生胎母输血综合征的孕妇外周血分别采用流式细胞术和血红蛋白电泳进行胎儿红细胞和HbF检测。结果胎儿红细胞数量与抗HbF单克隆荧光抗体的最佳反应比为5×10^(4)个∶6μL;流式细胞术检测结果与血红蛋白电泳及K-B法结果均具有一致性,该方法的灵敏度随流式细胞仪收集红细胞总量的增加而增加,抗HbF单克隆荧光抗体对除HbF外的血红蛋白变异体无染色,并且对固定及渗透处理后的红细胞悬液在90 d内的检测结果重复性好;90例孕妇外周血标本中成功检出2例胎母输血综合征。结论该研究建立了流式细胞术检测胎母输血综合征的非创伤性产前确诊方法。Objective To explore the value of combined detection of flow cytometry and hemoglobin electrophoresis in the diagnosis of fetomaternal hemorrhage.Methods Used the anti-fetal hemoglobin(HbF)monoclonal fluorescent antibody titer experiment to find out the optimal response ratio of the anti-HbF monoclonal fluorescent antibody to fetal red blood cells in the detection by flow cytometry.Then the accuracy,sensitivity,specificity and repeatability of the method were evaluated.Finally,fetal red blood cells and HbF were respectively detected by flow cytometry and hemoglobin electrophoresis in the peripheral blood of pregnant women with suspected FMH.Results The optimal ratio of fetal red blood cells to anti-HbF antibody was 5×10^(4)∶6μL.The results of flow cytometry were consistent with the results of hemoglobin electrophoresis and K-B method.The sensitivity of the method increased with the total amount of red blood cells collected by the flow cytometer.Anti-HbF monoclonal fluorescent antibody did not stain hemoglobin variants except HbF,and the detection results of the fixed and permeabilized red blood cell suspension within 90 days had good repeatability.Two cases of fetomaternal hemorrhage were successfully detected in the peripheral blood samples of 90 pregnant women.Conclusion A non-invasive prenatal diagnosis method for the detection of fetomaternal hemorrhage by flow cytometry is established.

关 键 词：胎母输血综合征 流式细胞术 血红蛋白电泳 胎儿红细胞 

分 类 号：R714.2[医药卫生—妇产科学]