直接抗人球蛋白试验阳性献血者与输血安全  

Direct antiglobulin test positive blood donors and blood transfusion safety

作　　者：揭小梅 何子毅[1] 胡应明[1] 贝孟辉[1] JIE Xiaomei;HE Ziyi;HU Yingming;BEI Menghui(Dongguan Central Blood Station,Dongguan 523000,China)

机构地区：[1]东莞市中心血站,广东东莞523000

出　　处：《中国输血杂志》2025年第4期578-584,共7页Chinese Journal of Blood Transfusion

基　　金：东莞市社会科技发展重点项目(20231800935932)。

摘　　要：直接抗人球蛋白试验(direct antiglobulin tests,DAT)又称直接Coomb′s试验,是血液免疫学中用于检测红细胞表面是否被免疫球蛋白或补体致敏的1种方法,主要应用于自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)、新生儿溶血性贫血、溶血性输血反应的诊断及输血时的配血。DAT阳性影响血液的输注疗效,一直是研究者关注的重点。近些年来,DAT阳性的类型鉴别及疾病分布特点在临床患者研究较多,在新生儿溶血病的研究也很热门,但多年来献血者DAT阳性的输注安全问题是输血界一直探讨的热点话题,并且国家尚未对DAT阳性血液的处理及DAT阳性献血者是否需献血屏蔽做明确要求。因此,本文就无偿献血者的DAT的免疫分型、IgG亚型分型的血清学相关研究,以及DAT阳性血液对输血安全的影响进行综述,以期为DAT阳性血液的发血策略和DAT阳性献血者是否要屏蔽,提供有益的参考。Direct antiglobulin test(DAT),also known as Coomb′s test,is a method used in blood immunology to detect whether the surface of red blood cells is sensitized by immunoglobulin or complement.It is mainly used in the diagnosis of autoimmune hemolytic anemia(AIHA),neonatal hemolytic anemia,hemolytic transfusion reaction and blood matching during blood transfusion.DAT positive has always been the focus of researchers,because it has an important impact on the efficacy of blood transfusion.In recent years,there has been extensive research on the identification of DAT positivity types and the distribution characteristics of diseases in clinical patients,and the study on hemolytic disease of the newborn has also been popular.However,the transfusion safety of DAT-positive blood donors has been a hot topic in the field of blood transfusion for many years.Moreover,there is no clear requirement from the state on the handling of DAT-positive blood and whether DAT-positive blood donors should be deferred from donation.Therefore,this article reviews the serological studies on DAT immunotyping and IgG subtype typing of voluntary blood donors,as well as the impact of DAT-positive blood on blood transfusion safety,in order to provide references for the blood issuance strategy of DAT-positive blood and whether DAT-positive blood donors should be deferred.

关 键 词：直接抗人球蛋白试验 献血者 血液免疫 献血招募 输血安全 

分 类 号：R457.11[医药卫生—治疗学]