不同免疫抗体检测技术在临床输血中的应用价值  

Application value of different immune antibody detection techniques in clinical blood transfusion

作　　者：王浩 王淑雅 嵇月红 Wang Hao;Wang Shuya;Ji Yuehong(Department of Blood Transfusion,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院输血科,江苏徐州221000

出　　处：《国际免疫学杂志》2023年第1期33-37,共5页International Journal of Immunology

摘　　要：目的探讨不同免疫抗体检测技术在临床输血中的应用价值。方法选取2019年1月至2021年1月在徐州医科大学附属医院需要进行临床输血治疗的1968例患者,分别采用微柱凝胶抗球蛋白法(microcolum gel Coomb's test,MGCT)、凝聚胺法、固相凝集法进行输血前抗体检测,以谱细胞检测为金标准,采用kappa一致性检验对比分析三种技术检测的一致性。结果MGCT和凝聚胺法检测不规则抗体与谱细胞鉴定的一致性Kappa值分别为0.84和0.72。MGCT与凝聚胺法检测不规则抗体效能的特异度及阴性预测值差异均无统计学意义(P>0.05),而MGCT检测的灵敏度、阳性预测值明显高于凝聚胺法检测,差异具有统计学意义(81.82%比72.73%,85.71%比72.73%,χ^(2)值分别为5.01、5.17,P值均<0.05)。MGCT和固相凝集法检测血小板抗体与谱细胞检测一致性的Kappa值分别为0.83和0.75。MGCT与固相凝集法检测血小板抗体效能的特异度及阳性预测值差异均无统计学意义(P>0.05),而MGCT检测的灵敏度和阴性预测值明显高于固相凝集法检测,差异具有统计学意义(90.17%比84.10%,81.19%比74.64%,χ^(2)值分别为6.53、6.11,P值均<0.05)。结论固相凝集法、凝聚胺法与MGCT比较,MGCT进行输血前免疫抗体检测效果显著,不仅可进行红细胞不规则抗体筛查,还可以进行血小板抗体筛查,值得临床推广。Objective To explore the application value of different immune antibody detection techniques in clinical blood transfusion.Methods A total of 1968 patients needing clinical blood transfusion in the Affiliated Hospital of Xuzhou Medical University were enrolled between January 2019 and January 2021.All underwent pre-transfusion antibody detection by microcolum gel Coomb's test(MGCT),polybrene method and solid-phase agglutination method.Taking spectral cells detection as the golden standard,consistency of the three techniques was compared and analyzed by Kappa consistency test.Results The consistency Kappa values between MGCT,polybrene method and the golden standard in the detection of irregular antibodies were 0.84 and 0.72 respectively.There was no statistically significant difference between the specificity and negative predictive value of MGCT and polyamine method in detecting irregular antibody efficacy(P>0.05),while the sensitivity and positive predictive value of MGCT were significantly higher than those of polyamine method(81.82%vs 72.73%,85.71%vs 72.73%,χ^(2) values were 5.01 and 5.17 respectively,both P values<0.05).The consistency Kappa values between MGCT,solid-phase agglutination method and the golden standard in the detection of platelet antibodies were 0.83 and 0.75 respectively.There was no statistically significant difference between the specificity and positive predictive value of platelet antibody detection by MGCT and solid-phase agglutination method(P>0.05),while the sensitivity and negative predictive value of MGCT were significantly higher than that by solid phase agglutination method(90.17%vs 84.10%,81.19%vs 74.64%,χ^(2) values were 6.53 and 6.11 respectively,both P values<0.05).Conclusion Compared with solid-phase agglutination method and polybrene method,the application effect of MGCT is more significant in pre-transfusion immune antibody detection.MGCT can be applied not only in cross-matching test and erythrocyte irregular antibody screening,but also in platelet antibody screening,whic

关 键 词：免疫抗体检测 输血 微柱凝胶抗球蛋白法 凝聚胺法 固相凝集法 

分 类 号：R457.1[医药卫生—治疗学] R446.6[医药卫生—临床医学]