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临床输血与检验

临床输血与检验 ›› 2019, Vol. 21 ›› Issue (5): 454-457.DOI: 10.3969/j.issn.1671-2587.2019.05.002

• 临床输血 • 上一篇    下一篇

改良微柱凝集试验在早期新生儿溶血病检测中的应用

李君, 张慧, 侯金友, 邹红蕊, 孙超, 崔振超   

  1. 063000 河北省唐山市开滦总医院输血科（李君,张慧,侯金友,邹红蕊）;
    唐山市中心血站（孙超）;
    秦皇岛市中心血站（崔振超）
  • 收稿日期:2018-05-19 出版日期:2019-10-20 发布日期:2019-10-29
  • 作者简介:李君（1985-）,女,天津人,主管技师,硕士,主要从事输血前免疫血液学试验研究,（Tel）13739882891（E-mail）278800026@qq.com。

Evaluation the Application Effect of Improved Microcolumn Agglutination Test for Early Detection of HDN

LI Jun, ZHANG Hui, HOU Jin-you, et al   

  1. Blood transfusion branch of Kailuan general hospital,Hebei 066000
  • Received:2018-05-19 Online:2019-10-20 Published:2019-10-29

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摘要： 目的 改良微柱凝集试验,并且探讨其在早期检测新生儿溶血病（hemolytic disease of newborn,HDN）中的应用效果。方法 分别从反应时间：15 min、30 min,细胞浓度：0.5%、1.0%,处理细胞试剂：低离子强度盐溶液（LISS液）、木瓜酶;血清细胞比例：2∶1、4∶1方面改良微柱凝集试验,使用IgG抗-D试剂进行模拟试验,利用极差分析法寻找最佳试验方案;产科送检怀疑母婴血型不合导致的HDN标本90例,进行溶血三项试验,其中放散试验均采用热放散,分别采用经典抗球蛋白试验（对照组）和改良微柱凝集试验（实验组）进行游离试验和放散试验,比较两种方法的检测效果。结果 ①改良微柱凝集试验最佳检测方案：反应时间30 min,细胞浓度1.0%,处理细胞试剂为木瓜酶,血清细胞比例2∶1,其中处理细胞试剂对检测结果影响最大。②90例可疑病例中36例确诊HDN均为ABO系统,其中A型21例,B型15例,不同血型患HDN的差异无统计学意义（χ2=0.008,P=0.931）;直抗阳性12例。③游离、放散试验结果显示,实验组检出效果均优于对照组（χ2=3.988,P=0.046;χ2=4.261,P=0.039）,说明改良微柱凝集试验在早期诊断HDN的检测效果优于经典抗球蛋白试验。结论 改良微柱凝集试验的最佳试验方案是反应时间30 min、细胞浓度为1.0%、处理细胞试剂为木瓜酶、血清细胞比例2∶1;改良微柱凝集试验检测HDN的效果优于经典抗球蛋白试验,能为实验室早期诊断提供可靠的试验依据。

关键词: 改良微柱凝集试验, 经典抗球蛋白试验, 新生儿溶血病

Abstract: Objective To improve microcolumn agglutination test,then discuss the effects on early detection of HDN.Methods The microcolumn agglutination test was improved from the aspects of reaction time（15min,30min）,cell concentration（0.5%,1%）,treatment of cell reagent（low ionic strength salt solution,papain） and serum cell ratio（2∶1,4∶1）,respectively. Second,The simulation experiment was carried out by using IgG anti -D reagent,and the best scheme was found by the range analysis method. Three hemolysis experiment were carried out for the 90 cases of suspected HDN send from obstetric. Tossing in test was using thermal radiation method. Classic antiglobulin test （control group） and improved microcolumn agglutination test （experimental group） were used respectively for free trials and radiation test. Finally,statistical methods were used to compare the two methods.Results ①The optimal detection scheme of improved microcolumn agglutination test was the reaction time of 30 min,the cell concentration 1.0 %,the treatment of cell reagent papain,and the proportion of serum and cell 2∶1,among them cell reagents had the greatest impact on detection results. ②In the 90 suspected HDN cases,36 cases were diagnosed as HDN,21 cases of type A,15 cases of type B. There was no statistically significant difference in different type of HDN（χ2=0.008,P=0.931）. ③The positive rates of improved microcolumn agglutination test were higher than classical antiglobulin test（χ2=3.988,P=0.046; χ2=4.261,P=0.039）. It showed that improved microcolumn agglutination test was better than classical antiglobulin test for the early detection of HDN.Conclusion sThe best experimental scheme of improved microcolumn agglutination test was reaction time 30 min,cell concentration 1.0 %,treatment of cell reagent papain,and the proportion of serum and cell 2∶1. The improved microcolumn agglutination test was better than classical antiglobulin test for the detection of HDN,which could provide more reliable test basis for early diagnosis.

Key words: Improved microcolumn agglutination test, Classical antiglobulin test, HDN detection

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