凝聚胺法筛查Rh系统意外抗体温度参数优化  

Optimization of temperature parameters for screening unexpected antibodies in Rh system by manual polybrene test

作　　者：邹昕 陈敏洁 马思飞 杨红梅[1] ZOU Xin;CHEN Minjie;MA Sifei;YANG Hongmei(Changzhou Blood Center Changzhou Key Laboratory of Clinical Blood Transfusion,Changzhou 213000,China.)

机构地区：[1]常州市中心血站常州市临床输血重点专科实验室,江苏常州213000

出　　处：《中国输血杂志》2025年第1期97-100,105,共5页Chinese Journal of Blood Transfusion

基　　金：常州市科技局项目(CJ20241124);常州市科技局项目(CJ20245046);江苏省英科新创科研基金课题(JSYK2023018);常州市中心血站站级课题(XZ202305)。

摘　　要：目的研究影响凝聚胺试验的温度参数,确定适合检测Rh系统意外抗体的最优温度条件。方法利用凝聚胺的方法检测不同稀释度的IgG型人源抗-D(原液,1∶2,1∶4,1∶8,1∶16,1∶32,1∶64)与D抗原阳性的红细胞反应,设置不同温度(25℃、37℃),加入低离子介质的反应时间4 min,分别比较抗-D的凝集积分值和红细胞解聚时间,观察凝集反应增强的效果,以此确立增强凝聚胺法的试验温度反应条件。将同样的反应条件应用于36例含Rh系统意外抗体血液标本,与凝聚胺法及抗球蛋白法(柱凝集)比较,观察增强凝聚胺法的效果。结果基于其它条件不变时,1)加入低离子介质后的孵育温度25℃与37℃,抗-D的凝集总积分值(20.9±2.025 vs 25.5±2.635)比较有差异(P<0.05)。2)抗体稀释度1∶16时孵育温度25℃与37℃,凝集积分值分别为(3.9±0.738 vs 5.8±0.632)比较有差异(P<0.05),红细胞解聚时间(62.8±8.149 vs 90.1±10.713)比较有差异(P<0.05);稀释度1∶32时孵育温度25℃与37℃,凝集积分值(2.5±0.527 vs 4.3±0.675)比较有差异(P<0.05),红细胞解聚时间(35.4±7.792 vs 57.4±10.885)比较有差异(P<0.05),其余组内没有差异。3)36例Rh系统意外抗体标本检测,当抗体效价≤2时,增强凝聚胺法阳性率更高,当抗体效价≥4时,3种方法检出率一致。结论增强凝聚胺法温度参考条件为加入低离子介质37℃孵育4 min,此温度条件应用于Rh系统意外抗体标本可达到明显的增强效果,为救治急诊输血患者增加了输血安全,值得推广使用。Objective To explore the temperature parameters affecting the polybrene test and determine the optimal temperature conditions for detecting unexpected antibodies of the Rh system.Methods The reaction of IgG human anti-D antibody with different dilutions(undiluted,1∶2,1∶4,1∶8,1∶16,1∶32,1∶64)with D antigen-positive red blood cells was detected by manual polybrene test(MPT).Different temperatures(25℃and 37℃)were set,and the reaction time with low ionic medium was 4 minutes.The agglutination integral value of anti-D and red cell depolymerization time were compared to observe the effect of enhanced agglutination reaction,thereby establishing the test temperature reaction conditions for enhancing the MPT.The same reaction condition was applied to 36 blood samples containing unexpected antibodies of the Rh system,and the effect of enhanced MPT was observed in comparison with the polybrene method and the antiglobulin test(column agglutination).Results With all other conditions held constant,when low ionic medium was added,the incubation temperature of 25℃and 37℃resulted in different total agglutination integral values for anti-D(20.9±2.025 vs 25.5±2.635),and the comparison showed a significant difference(P<0.05).When the antibody dilution was 1∶16,the incubation temperature of 25℃and 37℃resulted in different agglutination integral values(3.9±0.738 vs 5.8±0.632),and the comparison showed a significant difference(P<0.05).Erythrocyte depolymerization time(62.8±8.149 vs 90.1±10.713)was significantly different(P<0.05).At a dilution of 1∶32,the incubation temperatures of 25℃and 37℃resulted in different agglutination integral values(2.5±0.527 vs 4.3±0.675),as well as different red blood cell dissociation times(35.4±7.792 vs 57.4±10.885)(P<0.05),and the comparison showed a significant difference(P<0.05),with no differences observed in the other groups.In the detection of 36 Rh system unexpected antibody samples,when the antibody titer was≤2,the enhanced polybrene method had a higher po

关 键 词：凝聚胺法 意外抗体鉴定 温度 

分 类 号：R446[医药卫生—诊断学]