人红细胞类同种特异性自身抗体的血清学试验分析与研究  

Serological Test Analysis and Study of Mimicking Antibodies

作　　者：范亮峰[1] 丁蔚[1] 陆琼[1] 刘曦[1] 龚国琴 王中英[1] 向东[1] FAN Liangfeng;DING Wei;LU Qiong;LIU Xi;GONG Guoqin;WANG Zhongying;XIANG Dong(Shanghai Blood Center,Shanghai 200051)

机构地区：[1]上海市血液中心,上海200051

出　　处：《临床输血与检验》2024年第5期651-655,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的近年来,实验室临床样本的检测中,类同种特异性自身抗体(以下简称“类抗体”)样本检出率不断增加。抗球蛋白微柱凝集卡技术逐渐普及应用,进一步提高了类抗体检出率。为了研究类抗体实验室检测特点,探讨类抗体输血原则,本文进行了回顾性数据分析,为产生类抗体的患者提供有效的检测方法和临床建议。方法对160名产生类抗体的受检者进行详细的性别、年龄、诊断、血清学试验等回顾性分析。分析实验所得数据,找寻相关规律。结果类抗体最常见特异性为RH血型类抗体,包括类抗-Ce,类抗-Ec和类抗-D等占94.48%。CCDee分型是类抗体受检者最常见分型。血清微柱凝集卡法检测类抗体反应性较强(类抗体计分值最高:7.16分)。血清试管抗球蛋白法反应强度差异性最为显著,鉴别类抗体特异性较好。结论鉴定类抗体特异性比较困难,建议选择多种鉴定方法。微柱凝集卡法检测类抗体的反应性较强,抗球蛋白法鉴别类抗体特异性较好,建议此两种方法联合使用。输血治疗时应尽量避开类抗体特异性,输注相应抗原阴性的红细胞。Objective Through the research of many cases of mimicking antibodies,To study the characteristics of mimicking antibodies and explore the transfusion principles of mimicking antibodies.Provide effective detection methods and clinical suggestions for patients with mimicking antibodies.Methods A retrospective analysis was made on the sex,age,diagnosis and serological test of 160 cases of mimicking antibodies.Analyze the experimental data and find the relevant rules.Results The specificity of RH blood group antibodies is the most common in all mimicking antibodies.Mimicking antibodies of anti-Ce,anti-Ec and anti-D accounted for 94.48%in 160 cases.The type of CCDee is the most common type in all cases.GEL test in serum showed strong antibody reactivity(the score was 7.16).Indirect antiglobulin test in serum with tube showed strong specificity.Conclusion It is suggested that a variety of identification methods should be employed because it's difficult to identify the specificity of mimicking antibodies.The GEL test is more reactive in detecting antibodies and Indirect antiglobulin test method is more specific in distinguishing antibodies.The two methods should be combined.Blood transfusion treatment should be as far as possible to avoid mimicking antibody specificity,transfuse corresponding antigen negative of red blood cells will have obvious therapeutic effect on the patients.

关 键 词：类抗体 自 身抗体 类抗-Ce 抗球蛋白试验 

分 类 号：R446.6[医药卫生—诊断学]