三种血小板抗体检测方法的方法学对比研究  

Three platelet antibody detection methods:a comparative study

作　　者：张冬民[1] 李京 师丽佳 刘涛 丁月平[1] ZHANG Dongmin;LJing;SHI Lija;LIU Tao;DING Yueping(Taizhou Blood Station,Taizhou 225300,China;Baorui Biotechnology(Taizhou)Co Ld.Corresponding)

机构地区：[1]泰州市中心血站,江苏泰州225300 [2]宝锐生物科技泰州有限公司

出　　处：《中国输血杂志》2022年第11期1164-1166,共3页Chinese Journal of Blood Transfusion

摘　　要：目的 探讨血小板抗体不同方法学检测差异。方法 83份经临床评估血小板输血无效标本进行不同方法检测比较,包含:固相酶联免疫吸附检测、液相芯片检测、固相凝集捕获检测,评估不同检测方法的敏感度、重复性与一致性。结果 83份标本中3种方法一致性结果为71份(62份阳性,9份阴性),液相芯片检测与酶联免疫吸附检测一致性为95.2%(Kapp值:0.829,P<0.05);酶联免疫吸附检测与固相凝集捕获检测一致性为85.5%(Kapp值:0.512,P<0.05);液相芯片检测与与固相凝集捕获检测一致性为90.3%(Kappa值:0.636,P<0.05)。12份检测不一致标本中,3份仅有固相凝集捕获检测阳性,其他方法阴性,与6位随机献血者交叉配血结果呈现部份交叉配血结果不相合;5份为仅有固相凝集捕获检测阴性,皆为HLA抗体所致;其余4份的固相凝集捕获检测与液相芯片检测皆为阳性,固相酶联免疫吸附检测为阴性。结论 3种检测方法一致性为85.5%,不同方法有各自局限性。固相凝集捕获检测具备快速、中国注册与经济优势可作为初步筛选;液相芯片检测具备最佳诊断力但是用于高通量与HPA/HLA抗体分析;固相酶联免疫吸附检测具备方便操作的优势。联合多种检测方法使用可有效诊断血小板抗体检测。Objective To compare three kinds of platelet antibody detection methods used to identify alloantibodies in patients with platelet transfusion refractory(PTR). Methods The 83 samples from PTR patients were analyzed base on three different methods, including solid phase ELISA, Luminex, and capture. The sensitivity, reproducibility, and consistency of different kits were evaluated. Results A total of 71(62 positive and 9 negative) out of 83 samples showed consistent results by three methods. The consistency between Luminex and solid phase ELISA was 95.2%(Kapp value=0.829, P<0.05), between solid phase ELISA and capture method was 85.5%(Kapp value=0.512, P<0.05), and between Luminex and capture method was 90.3%(kappa value=0.636, P<0.05). Among the 12 samples with inconsistent results, 3 cases presented positive results by capture method alone and negative by other methods, which had incompatible cross-matching results with 6 random blood donors;5 cases with HLA antibodies showed negative results by capture method alone and positive by both Luminex and solid phase ELISA;the other 4 cases were positive in both capture and Luminex, but negative in solid phase ELISA. Conclusion The consistency of three methods was 85.5%, and each has its limitations. The capture method is rapid, economic and registered domestically, which can be used for preliminary screening.Luminex has the optimal diagnostic performance, which can be used for high-throughput and HPA/HLA antibody analysis. The solid phase ELISA is convenient. The combination of them can detect platelet antibodies effectively.

关 键 词：血小板抗体检测 固相酶联免疫吸附检测 液相芯片检测 固相凝集捕获检测 

分 类 号：R457.1[医药卫生—治疗学] R331.143[医药卫生—临床医学]