改良微管法交叉配血试剂爆珠的研制  

Research on a new microtubule technology of reagent bursting for crossmatching test

作　　者：马印图 杨晓亚 赵义曼 陈莉[2] 高磊[1] 周景艳 闫浩[1] 李莉华[2] MA Yintu;YANG Xiaoya;ZHAO Yiman;CHEN Li;GAO Lei;ZHOU Jingyan;YAN Hao;LI Lihua(Department of Blood Transfusion,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Hebei Blood Center)

机构地区：[1]中国人民解放军联勤保障部队第九八○医院输血科,河北石家庄050082 [2]河北省血液中心

出　　处：《中国输血杂志》2023年第6期478-482,共5页Chinese Journal of Blood Transfusion

基　　金：2022年度医院科技创新“孵育”计划项目(FYJH-ZD02)。

摘　　要：目的研制1种新型输血前交叉配血技术方法,在战时和自然灾害等突发情况下不需要电力设备和额外试剂即可快速、准确完成交叉配血,提高野战输血救治的时效性和安全性。方法采用200μL不完全抗体快速促凝剂作为反应介质,将其包裹在爆珠中制成试剂爆珠,预置在检测管内,使用前挤破爆珠,促凝剂留在孔内,在主侧管加入受血者血浆200μL和献血者3%~5%的红细胞悬液100μL,次侧管加入献血者血浆200μL和受血者3%~5%的红细胞悬液100μL,手工摇动微管或1500 g离心15 s即可完成交叉配血试验。同时与现有技术方法平行对比测试,评价爆珠试剂用于交叉配血试验的可靠性。结果爆珠试剂置于37℃放置1周后与新鲜制备的交叉配血试剂检测结果一致,显示其野外实用性和室温条件下的稳定性良好;灵敏度与微柱凝胶法检测结果经配对资料t检验,(t=2.03,P>0.05),结果无统计学差异;50例临床标本采用微柱凝胶法和促凝剂爆珠技术进行平行交叉配血试验,经Kappa检验,Kappa值为0.9732,均检出了2例不规则抗体,二者的符合率为100%,一致性良好。结论改良微板法爆珠技术简单快速,用于输血前相容性检测结果安全可靠,特别适合战时和突发自然灾害情况下野外抢救伤员输血前使用,值得推广应用。Objective To develop a quick and accurate crossmatching test technology without the power equipment and additional reagents before blood transfusion,so as to improve the timeliness and safety of blood transfusion treatment in sudden sit⁃uations as war or natural disasters.Methods The irregular anti-bodies quickly promote coagulants(QPC)were used as the reaction medium reagent.The 200μL QPC were wrapped in the bursts bead and preset within different recess of the detection tubes.The bursts beads were squeezed with the reagent left in the well,then the blood samples were dropped in the main(recipient plasma:200μL,donor 3%—5%RBC:100μL)and secondary(donor plasma:200μL,recipient 3%—5%RBC:100μL)reaction grooves.The result interpretated by hand wres⁃tling or 1500 g centrifugation of 15 seconds.Meanwhile,the comparing experiments with the prior methods were implemented to evaluate the method’s reliability.Results The results of the bursting reagent,being stored at 37℃for one week,were consistent with those of the freshly prepared cross-matching reagent,indicating that the bursting reagent was practical in the field and had good stability at normal temperature.No statistical difference between the sensitivity and the results of the mi⁃crocolumn gel method was noticed by paired data t test(P>0.05).The parallel cross matching tests of 50 clinical samples were performed by microcolumn gel method and coagulant-bursting technique;the Kappa value was 0.9732,and irregular antibodies were detected in 2 cases,with concordance rate at 100%,showing good consistency.Conclusion The improved method is simple and fast,and also safe and reliable for compatibility testing before blood transfusion,which is especially suitable for the field rescue of the wounded in wartime and sudden natural disasters,and is worthy of popularization.

关 键 词：野战输血 交叉配血 爆珠技术 快速促凝剂 输血安全 

分 类 号：R446.11[医药卫生—诊断学] TQ421.7[医药卫生—临床医学]