盐水介质试管法与柱凝集法在红细胞意外抗体检测中的比对分析  

Comparative Analysis of the Saline Medium Tube Method and Column Agglutination Method in the Detection of Unexpected Red Blood Cell Antibodies

作　　者：高城燕 龚国琴 蔡晓红[2] 向东[1] GAO Chengyan;GONG Guoqin;CAI Xiaohong;XIANG Dong(Shanghai Blood Center;Department of Transfusion Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025)

机构地区：[1]上海市血液中心 [2]上海交通大学医学院附属瑞金医院临床输血科,上海200025

出　　处：《临床输血与检验》2025年第2期175-179,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：国家自然科学基金(No.82070194、No.82370229)资助。

摘　　要：目的通过对比抗人球蛋白微柱凝集法与传统的盐水介质试管法在红细胞意外抗体检测中的效能,探索在抗人球蛋白微柱凝集法进行抗体筛查的同时,进行盐水介质试管法抗筛的价值。方法研究分析了2014年1月—2024年12月上海血液中心进行意外抗体筛查的样本2518例。对盐水介质试管法中检出阳性的抗M、抗Le^(a)、抗Mur、抗Le^(b)、抗P_(1)、抗Di^(a)、抗Fy^(b)以及抗S等八种抗体进行回顾性分析,选择盐水介质试管法及抗人球蛋白微柱凝集法平行检测的案例进行比对研究,采用Mcnemar检验(配对卡方检验)评估差异性。结果抗体检出率:抗M,盐水介质试管法96%,抗人球蛋白微柱凝集法62%;抗Le^(a),盐水介质试管法60%,抗人球蛋白微柱凝集法97%;抗Mur,盐水介质试管法60%,抗人球蛋白微柱凝集法97%;抗Le^(b),盐水介质试管法84%,抗人球蛋白微柱凝集法70%;抗P_(1),盐水介质试管法89%,抗人球蛋白微柱凝集法40%;抗Di^(a),盐水介质试管法10%,抗人球蛋白微柱凝集法99%;抗Fy^(b),盐水介质试管法4%,抗人球蛋白微柱凝集法88%;抗S,盐水介质试管法16%,抗人球蛋白微柱凝集法99%。结论抗人球蛋白微柱凝集法在多数意外抗体的检出上优于传统的盐水介质试管法,尤其是在自动化程度高和操作简便性方面。盐水介质试管法仅在某些特定抗体(如抗M和抗P_(1))时仍显示出较高的敏感性。Objective To compare the effectiveness of the anti-human globulin microcolumn agglutination method and the traditional saline medium test tube method in detecting unexpected antibodies in red blood cells,and to explore the value of using both methods in parallel for antibody screening.Methods We retrospectively investigated 2518 samples from the Shanghai Blood Center,which underwent unexpected antibody screening between January 2014 and December 2024.Our study focused on the detection of eight types of antibodies(anti-M,anti-Le^(a),anti-Mur,anti-Le^(b),anti-P_(1),anti-Di^(a),anti-Fy^(b),and anti-S)using the saline test tube method.Cases where both the saline medium test tube and the anti-human globulin microcolumn agglutination methods were used in parallel were selected for comparison.Data were analyzed using SPSS 22.0,and differences were assessed with McNemar's test(paired chi-square test).Results The detection rates for the antibodies were as follows:anti-M(96%by the saline method vs.62%by the microcolumn method),anti-Le^(a)(60%vs.97%),anti-Mur(60%vs.97%),anti-Le^(b)(84%vs.70%),anti-P_(1)(89%vs.40%),anti-Di^(a)(10%vs.99%),anti-Fy^(b)(4%vs.88%),and anti-S(16%vs.99%).Conclusion The anti-human globulin microcolumn agglutination method outperforms the traditional saline medium test tube method in detecting most unexpected antibodies,offering advantages in automation and ease of use.However,the saline test tube method shows higher sensitivity for certain antibodies(e.g.,anti-M and anti-P_(1)),though the clinical significance of these antibodies remains unclear and warrants further investigation.

关 键 词：抗人球蛋白微柱凝集法 盐水介质试管法 意外抗体 

分 类 号：R446.11[医药卫生—诊断学]