采用微柱凝胶抗球蛋白法与凝聚胺法行输血前抗体检测在临床输血中的应用价值  

Application value of microcolumn gel antiglobulin method and polyamine method in detection of antibodies before blood transfusion in clinical blood transfusion

作　　者：杨薇 张玲 刘小毅 Yang Wei;Zhang Ling;Liu Xiaoyi(Department of Clinical Laboratory,the 73rd Army Hospital of the PLA,Xiamen 361000,Fujian,China;Department of Intensive Care Medicine,the 73rd Army Hospital of the PLA,Xiamen 361000,Fujian,China)

机构地区：[1]中国人民解放军陆军第七十三集团军医院检验科,福建厦门361000 [2]中国人民解放军陆军第七十三集团军医院重症医学科重症病区,福建厦门361000

出　　处：《实用检验医师杂志》2024年第4期369-372,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨采用微柱凝胶抗球蛋白法与凝聚胺法行输血前抗体检测在临床输血中的应用价值。方法选择2023年1月—2024年5月陆军第七十三集团军医院收治的425例需行临床输血患者作为研究对象,所有患者均接受微柱凝胶抗球蛋白法和凝聚胺法抗体检测,并采用微柱凝胶抗球蛋白法对交叉配血不合者实施不规则抗体检测。比较两种检查方式的检测结果、配血时间,记录并分析两种检查方式的交叉配血不合原因,并比较两种检查方式不规则抗体检测结果。结果微柱凝胶抗球蛋白法检测的主侧、次侧阳性率以及总阳性率均显著高于凝聚胺法,差异均有统计学意义〔主侧阳性率:2.59%(11/425)比0.71%(3/425);次侧阳性率:4.24%(18/425)比0.94%(4/425);总阳性率:6.82%(29/425)比1.65%(7/425);均P<0.05〕。微柱凝胶抗球蛋白法和凝聚胺法检测的假阳性率比较差异无统计学意义〔0.24%(1/425)比0.94%(4/425),P>0.05〕;微柱凝胶抗球蛋白法的配血时间显著长于凝聚胺法,差异有统计学意义(min:33.25±5.01比12.01±3.65,P<0.05)。微柱凝胶抗球蛋白法的主侧、次侧不规则抗体阳性率以及总不规则抗体阳性率均高于凝聚胺法,但差异均无统计学意义〔主侧不规则抗体阳性率:90.91%(10/11)比33.33%(1/3);次侧不规则抗体阳性率:55.56%(10/18)比25.00%(1/4);总不规则抗体阳性率:68.97%(20/29)比28.57%(2/7);均P>0.05〕。采用微柱凝胶抗球蛋白法检出的29例配血不合患者中包括血液病18例(占62.07%),肾病2例(占6.90%),自身免疫性溶血性贫血2例(占6.90%),孕产妇2例(占6.90%),既往有输血史5例(占17.24%);凝聚胺法检出的7例配血不合患者中包括自身免疫性溶血性贫血1例(占14.29%),血液病4例(占57.14%),孕产妇1例(占14.29%),既往有输血史1例(占14.29%)。结论微柱凝胶抗球蛋白法与凝聚胺法各有优缺点,前者敏感度较高,结果可靠,后者配血时间短,必要时可联合使用,为临Objective To explore the application value of microcolumn gel antiglobulin method and polyamine method in the detection of antibodies before blood transfusion in clinical blood transfusion.Methods The 425 patients who were admitted to the 73rd Army Hospital of the PLA from January 2023 to May 2024 and needed clinical blood transfusion were selected as research objects.All of them were examined using microcolumn gel antiglobulin method and polyamine method,and irregular antibodies were detected using microcolumn gel antiglobulin method in patients with cross matching incompatibility.The test results and blood matching time of two examination methods were compared,the reasons for cross matching incompatibility between the two examination methods were recorded and analyzed,and the irregular antibody detection results of the two examination methods were compared.Results The main positive rate,secondary positive rate and total positive rate of microcolumn gel antiglobulin method were significantly higher than those of polyamine method[main positive rate:2.59%(11/425)vs.0.71%(3/425);secondary positive rate:4.24%(18/425)vs.0.94%(4/425);total positive rate:6.82%(29/425)vs.1.65%(7/425);all P<0.05].There was no significant difference in the false positive rate between microcolumn gel antiglobulin method and polyamine method[0.24%(1/425)vs.0.94%(4/425),P>0.05].The blood matching time using microcolumn gel antiglobulin method was significantly longer than that using polyamine method(minutes:33.25±5.01 vs.12.01±3.65,P<0.05).The main positive rate,secondary positive rate and total positive rate of irregular antibodies by microcolumn gel antiglobulin method were higher than those by polyamine method,but there were no statistical differences[main positive rate:90.91%(10/11)vs.33.33%(1/3);secondary positive rate:55.56%(10/18)vs.25.00%(1/4);total positive rate:68.97%(20/29)vs.28.57%(2/7);all P>0.05].The 29 cases of blood matching incompatibility detected by microcolumn gel antiglobulin method included 18 cases of blood diseases(

关 键 词：输血 微柱凝胶抗球蛋白法 抗体检测 凝聚胺法 

分 类 号：R44[医药卫生—诊断学]