2种试剂检测ABO新生儿溶血病结果比较及放散液与试剂红细胞比例的优化  

Comparison of two ABO reagent release tests for neonatal hemolytic disease and the optimization of the ratio of released liquid to reagent erythrocyte in release test

作　　者：闵志军[1,2] 张建伟 曹锁春[1] 徐立[1] 许飞[1,2] MIN Zhijun;ZHANG Jianwei;CAO Suochun;XU Li;XU Fei(Changzhou Blood Center,Changzhou,213004,China;Changzhou Key Specialty Laboratory of Clinical Blood Transfusion)

机构地区：[1]常州市中心血站,江苏常州213004 [2]常州市临床输血重点专科实验室

出　　处：《临床血液学杂志》2023年第10期712-715,共4页Journal of Clinical Hematology

基　　金：江苏省输血协会爱康生物科研基金资助项目(No:JSAK202013);常州市中心血站站级课题(No:xz202108)。

摘　　要：目的:比较ABO新生儿溶血病(hemolytic disease of the newborn, HDN)2种检测试剂放散试验的阳性检出率,探讨微柱凝集技术放散试验中放散液与试剂红细胞不同比例对阳性检出率的影响。方法:2种试剂(上海润普和长春博讯)参考试剂说明书推荐的放散液和试剂红细胞比例同时检测符合临床诊断标准的ABO HDN标本,比较2种试剂放散试验的阳性检出率。另外在固定试剂红细胞浓度为0.8%、体积为50μL的情况下,上海润普试剂放散试验中放散液与试剂红细胞按不同比例(0.5∶1、1∶1、1.5∶1、2∶1、2.5∶1)进行检测,比较不同比例下的ABO HDN的阳性检出率。结果:参考试剂说明书推荐的比例进行放散试验,上海润普(0.5∶1)和长春博讯(1∶1)阳性检测率分别为83.72%(545/651)和84.49%(550/651),2种试剂ABO HDN的阳性检出率差异无统计学意义(P>0.05);上海润普试剂随着放散液与试剂红细胞比例从0.5∶1、1∶1、1.5∶1、2∶1、2.5∶1逐步增加,阳性检出率也相应增加,在增加至比例为2.5∶1时,阳性检出率最高(P<0.05)。结论:参考试剂说明书推荐的比例进行放散试验,2种检测试剂阳性检出率差异无统计学意义,但是2种试剂均出现阳性病例漏检情况;上海润普试剂在增加放散液与试剂红细胞比例(由试剂说明书推荐的0.5∶1增加至2.5∶1)后,可以提高ABO HDN阳性检出率,最大程度上减少ABO HDN漏检的发生。Objective To compare the positive rate of ABO hemolytic disease of the newborn(HDN) in two reagent release tests, and to investigate the effect of different proportions of released liquid and reagent red blood cells on the positive detection rate in the release test of microcolumn agglutination technology.Methods ABO HDN specimens meeting the clinical diagnostic criteria were detected at the same time with the proportions of released fluid and red blood cells recommended by the two reagents(Shanghai Runpu and Changchun Boxun) in the reference manual, and the positive detection rates of the two reagents were compared. In addition, when the concentration of fixed reagent red blood cells was 0.8% and the volume was 50 μL, the released liquid and reagent red blood cells were detected in different ratios(0.5∶1, 1∶1, 1.5∶1, 2∶1, 2.5∶1) in the reagent release test of Shanghai Runpu, and the positive detection rates of ABO HDN under different ratios were compared.Results The ABO HDN positive rates of Shanghai Runpu(0.5∶1) and Changchun Boxun(1∶1) were 83.72%(545/651) and 84.49%(550/651), respectively. There was no difference in the ABO HDN positive rates between the two reagents(P>0.05). The positive detection rate of Shanghai Runpu reagent increased gradually with the ratio of released fluid to red blood cells from 0.5∶1, 1∶1, 1.5∶1, 2∶1 and 2.5∶1, and the positive detection rate was the highest when the ratio was increased to 2.5∶1(P < 0.05).Conclusion There was no difference in the positive detection rate of the two reagents by referring to the ratio recommended in the reagent description. However, both reagents failed to detect positive cases. After increasing the ratio of released liquid to reagent erythrocyte(from 0.5∶1 recommended in the reagent description to 2.5∶1), the positive detection rate of ABO HDN of Shanghai Runpu reagent can be increased and the occurrence of ABO HDN missed detection can be reduced to the greatest extent.

关 键 词：ABO新生儿溶血病 微柱凝集法 放散液与试剂红细胞比例 血清总胆红素 放散液效价 

分 类 号：R556.6[医药卫生—血液循环系统疾病]