4种微柱凝集抗人球蛋白卡意外抗体筛查结果比对分析  

Four microcolumn agglutination anti-human globulin cards in unexpected antibody screening results:a comparative analysis

作　　者：宋轲 马春娅 付丽辉 肖潘 师红梅 于洋 SONG Ke;MA Chunya;FU Lihui;XIAO Pan;SHI Hongmei;YU Yang(Department of Transfusion Medicine,the First Medical Center of Chinese PLA Ceneral Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一医学中心输血医学科,北京100853

出　　处：《中国输血杂志》2024年第12期1405-1411,共7页Chinese Journal of Blood Transfusion

摘　　要：目的分析1种进口和3种国产微柱凝集抗人球蛋白卡在意外抗体筛查试验中的检测能力。方法选取本院2022年7—9月抗体筛查试验阳性标本104例,通过微柱凝集抗球蛋白试验,同时对1种进口卡(A卡)和3种国产卡(B、C、D卡)完成抗体筛查平行对比试验,分析其灵敏度、特异性、凝集强度积分等差异。结果4种抗人球蛋白卡灵敏度D卡88.51%(131/148)>C卡83.22%(124/149)>B卡81.63%(120/147)>A卡80.54%(120/149);特异性A卡97.79%(133/136)>B卡95.65%(132/138)>D卡95.62%(131/137)>C卡93.38%(127/136);凝集强度积分秩平均值D卡214.57分>C卡191.90分>A卡179.69分>B卡175.83分,Kruskal-Wallis检验H值为7.221,差异比较无统计学意义(P>0.05)。其中,C卡易出现假阳性,占3.16%(9/285),A卡易出现假阴性,占10.18%(29/285)。结论不同厂家抗人球蛋白卡的检测能力存在差异,部分国产卡检测性能高于进口卡。建议临床常规使用两种厂家的抗人球蛋白卡,即使用检测灵敏度高的卡进行抗体筛查试验,尽可能避免抗体漏检,使用特异性高的卡进行交叉配血试验,避免因为假阳性导致延迟输血,耽误输血治疗。Objective To analyze the detection ability of one imported and three domestic microcolumn agglutination anti-human globulin cards in unexpected antibody screening test.Methods A total of 104 positive samples from antibody screening test conducted at our hospital from July to September 2022 were selected.Microcolumn agglutination antiglobulin tests were performed in parallel with antibody screening tests using one imported card(A Card)and three domestic cards(B,C and D Cards)to analyze the differences in the sensitivity,specificity and agglutination intensity scores.Results The sensitivity of the four anti-human globulin cards was as follows:D card 88.51%(131/148)>C card 83.22%(124/149)>B card 81.63%(120/147)>A card 80.54%(120/149);the specificity was A card 97.79%(133/136)>B card 95.65%(132/138)>D card 95.62%(131/137)>C card 93.38%(127/136);and the average agglutination in-tensity score(points)was D card 214.57>C card 191.90>A Card 179.69>B Card 175.83,and the H value of Kruskal-Wallis test was 7.221,with no statistically significant difference(P>0.05).Among them,C card was prone to false posi-tives,accounting for 3.16%(9/285),and A card was prone to false negatives,accounting for 10.18%(29/285).Con-clusion There were differences in the detection ability of anti-human globulin cards of different manufacturers,and some domestic cards have higher detection performance than imported cards.It is recommended to use anti-human globulin cards of two manufacturers routinely in clinical practice,that is,to use cards with high detection sensitivity for antibody screening tests to avoid antibody missed detection as much as possible,and to use cards with high specificity for cross-matching blood tests to avoid delays in transfusion due to false positives,which could hinder transfusion treatment.

关 键 词：微柱凝集 抗人球蛋白卡 抗体筛查 意外抗体 

分 类 号：R446.61[医药卫生—诊断学] S852.43[医药卫生—临床医学]