微柱凝胶结合抗球蛋白技术检测抗抗生素药物抗体方法建立的探讨  

The Development of a Microcolumn Gel Combined with Antiglobulin Technique for the Detection of Antiantibiotic Drug Antibodies

作　　者：张媛[1] 徐菲[1] 包进[1] 董林[1] ZHANG Yuan;XU Fei;BAO Jin;DONG Lin(Department of Laboratory Medicine,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院医学检验科,江苏南京210006

出　　处：《标记免疫分析与临床》2023年第3期404-408,463,共6页Labeled Immunoassays and Clinical Medicine

基　　金：江苏省输血协会英科新创科研基金(抗生素导致药物性溶血的实验室诊断)(编号:Js2018012);江苏省医学重点学科建设单位(编号:JSDW202239)。

摘　　要：目的探讨建立采用微柱凝胶抗球蛋白检测筛选抗抗生素药物抗体的实验室方法。方法采用微柱凝胶结合抗球蛋白法检测446例使用抗生素患者血浆和红细胞放散液中抗生素药物诱导抗体。结果血浆中共检出75例抗抗生素药物抗体,阳性率分别为头孢哌酮31.25%、哌拉西林18.42%、美罗培南2.44%、头孢噻肟10%、头孢曲松21.43%,美罗培南与其余4种抗生素药物、头孢哌酮与哌拉西林及头孢噻肟、头孢曲松与头孢噻肟,阳性率之间差异有统计学意义(P<0.05)。红细胞DAT阳性率为13%(58例),DAT阳性和阴性的红细胞放散液中抗抗生素抗体阳性率分别为头孢哌酮47.82%和24.72%、哌拉西林46.15%和12.70%、头孢曲松100%和18.52%、头孢噻肟10%和10%;前3者在DAT阳性红细胞放散液中的抗生素药物抗体的阳性率明显高于后者(P<0.05)。结论无论直接抗球蛋白阳性与否,微柱凝胶结合抗球蛋白检测技术适用临床对于使用抗菌药物患者的血浆或红细胞放散液中的药物性抗体的检测。Objective A laboratory method for screening anti-β-lactam antibodies was established by using microcolumn gel combined with antiglobulin detection technology.Methods Antibiotic drug-induced antibodies were detected in plasma and red blood cells release fluid of 446 patients by microcolumn gel binding antiglobulin assay.Results There were 75 drug antibodies in plasma,the positive rates of antibodies were as following:31.25%in Cefoperazone,18.42%in Piperacillin,2.44%in Meropenem,10%in Cefotaxime,and 21.43%in Ceftriaxone,respectively.There were significant differences between the positive rates of Meropenem and other four antibiotics,Cefoperazone and Piperacillin and Cefotaxime,Ceftriaxone and Cefotaxime(P<0.05).The positive rate of DAT in red blood cells was 13%(58 cases),and the positive rates of antiantibiotic antibody in DAT positive and DAT negative red blood cell releases were 47.82%and 24.72%of Cefoperazone,46.15%and 12.70%of piperacillin,100%and 18.52%of ceftriaxone,10%and 10%of Ceftaxime,respectively.The positive rate of antibiotic antibody in DAT positive red blood cell release was higher in first three than that of the last(P<0.05).Conclusion Regardless of whether DAT is positive or not,microcolumn gel-conjugated antiglobulin detection techniques are suitable clinically to detect antibiotic pharmacological antibodies in plasma or RBCs release fluid.

关 键 词：抗生素 微柱凝胶法 药物包被红细胞 药物抗体 直接抗球蛋白实验 

分 类 号：R392-33[医药卫生—免疫学]