AB血浆倍比稀释在高效价自身抗体患者抗体筛查中的应用研究  

Application of Serial Dilution with AB Plasma in Antibody Screening for Patients with High Titer Autoantibodies

作　　者：任丽 李晓莉 肖松 李小飞 刘志忠[1] REN Li;LI Xiaoli;XIAO Song;LI Xiaofei;LIU Zhizhong(School of Rehabilitation,Capital Medical University,Beijing 100069;Blood Transfusion Department of Beijing Fengtai Youanmen Hospital,Beijing 100071;Blood Transfusion Department of Beijing Friendship Hospital,Capital Medical University,Beijing 100032)

机构地区：[1]首都医科大学康复医学院,北京100069 [2]北京丰台右安门医院输血科,北京100071 [3]首都医科大学附属友谊医院输血科,北京100032

出　　处：《临床输血与检验》2024年第1期66-71,共6页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨用AB血浆倍比稀释是否可替代盐水法进行同种抗体效价检测,并消除高效价自身抗体影响,检出同种抗体。方法选取四组标本进行检测:①6例自身抗体标本;②16例已知同种抗体的标本;③16例同种抗体+自身抗体混样标本(人为将6例自身抗体血浆和16例同种抗体血浆混合配成);④4例自身抗体且分别存在抗-C、抗-E、抗-Jka、抗-cE的受血者标本。对①②③组标本分别用盐水、AB血浆分别进行倍比稀释,用抗人球蛋白试验(微柱法)测效价,对④组标本用AB血浆稀释,用抗人球蛋白试验(微柱法)进行不规则抗体筛查。结果①组6例自身抗体标本用盐水倍比稀释法,效价均≥512,用AB血浆倍比稀释法,效价均≤4;②组仅一例效价为2的抗-M结果不一致,盐水稀释法为2,AB血浆稀释法为4,效价≥4时两者结果一致;③组用盐水法与AB血浆稀释法,在效价≥16时,两种方法结果无差异。效价<16时,盐水倍比稀释后效价均为16;AB血浆稀释法,同种抗体效价≥8时,可检出与原同种抗体效价一致,效价≤4时无法分辨同种抗体和自身抗体。④组分别存在抗-C、抗-E、抗-Jka、抗-cE抗体的四个含有自身抗体的受血者在AB血浆倍比稀释试验中,在1∶8效价试管中出现符合相应抗体筛查反应格局变化。结论在高效价自身抗体存在时盐水倍比稀释法极高,AB血浆倍比稀释法能消除1∶4效价试管后自身抗体的影响;AB血浆为倍比稀释液不影响同种抗体的效价检测,且略优于盐水倍比稀释法;AB血浆倍比稀释在高效价自身抗体存在的情况下,可根据三系抗体筛查格局的不同变化检出效价≥8的同种抗体存在,是一种较为简单的可避免自身抗体干扰的免疫血液学实验方法。Objective To explore whether the AB plasma dilution method can replace the saline method for alloantibody titer detection,or which method also can eliminate the influence of high titer autoantibodies,or detecting alloantibodies.Method Four groups of specimens were prepared for testing:①six samples with autoantibody;②sixteen samples with known alloantibody;③16 mixed samples using①and②(artificially mixed 6 autoantibody plasma and 16 known alloantibody plasma according to certain rules);④Four samples with autoantibodies which contain anti-C,anti-E,anti-Jka,and anti-CE alloantibodies,respectively.We serially diluted the samples of groups①,②,and③with saline or AB plasma,respectively and measured their titers using AHG test(microcolumn method).Diluted the samples of group④with AB plasma,and screened for irregular antibodies.Result①6 autoantibody samples in group were diluted with saline at titers of≥512,where as with AB plasma the titers of≤4;②only one pair of anti-M titer of 2 was inconsistent,which was 2 using the saline dilution method,and was 4 using the AB plasma dilution method.When the titers were≥4,the both results were consistent;③When their original titers≥16,there was no difference between the saline and AB plasma dilution method.When those titers<16,titers with saline dilution method keep 16.When the original titer of alloantibody≥8,the AB plasma dilution method can detect the same titers as the original same antibody.When the titer is≤4,it cannot distinguish between the alloantibody and the autoantibody.④In the AB plasma dilution test,there was a change in the pattern of antibody screening reaction in a 1∶8 test tube for four recipients with autoantibodies,which pattern corresponding with anti-C,anti-E,anti-Jka,and anti-CE antibodies respectively.Conclusion Extremely high titer autoantibodies are detected with the saline dilution method,where as the AB plasma dilution method can eliminate the influence of 1∶4 titer autoantibodies in test tubes;AB plasma as a dilu

关 键 词：自身抗体 AB血浆 稀释 抗人球蛋白试验(微柱法) 

分 类 号：R457[医药卫生—治疗学]