应用流式细胞术对自身免疫性溶血性贫血患者自身抗体掩盖下血型同种抗体检测的研究*

doi:10.3969/j.issn.1671-2587.2022.01.002

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (1): 6-10.DOI: 10.3969/j.issn.1671-2587.2022.01.002

应用流式细胞术对自身免疫性溶血性贫血患者自身抗体掩盖下血型同种抗体检测的研究*

赵俸涌, 张玉宇, 王中英, 徐婷, 李勤, 张嘉敏, 向东, 朱自严

200051 上海市血液中心

收稿日期:2021-10-14 发布日期:2022-01-27
通讯作者: 向东,男,主任技师,主要从事免疫血液学、血型血清学研究,（E-mail）xiangdong@sbc.org.cn。
共同通信作者：朱自严,男,研究员,主要从事免疫血液学、稀有血型研究,（E-mail）zhuziyan@sbc.org.cn。
作者简介:赵俸涌（1988-）,男,山西忻州人,助理研究员,博士,主要从事人类红细胞血型抗原及其功能、动物血型与输血方面研究,（E-mail）zhaofengyong@sbc.org.cn。
并列第一作者：张玉宇（1999-）,女,福建福鼎人,学士,主要从事人类红细胞血型与输血方面研究,（E-mail）zhangyuyu@sbc.org.cn。
基金资助:
*本课题受上海市卫健委青年课题（No.20184Y0281）; 中国输血协会威高基金项目（No.CSBT-WG-2019-08）; 上海市卫生健康委员会科研项目（No.202040503）; 上海市卫生健康委员会课题（No.2021HP40）; 上海市公卫三年行动计划项目（No.GWV-3.6）资助

Application of Flow Cytometry to the Detection of Blood Group Isoantibodies under the Cover of Autoantibodies in Autoimmune Hemolytic Anemia Patients

ZHAO Feng-yong, ZHANG Yu-yu, WANG Zhong-ying, et al

Shanghai Blood Center,Shanghai 200051

Received:2021-10-14 Published:2022-01-27

摘要/Abstract

摘要： 目的在自身免疫性溶血性贫血（自免溶贫）患者血样的检测中,自身抗体往往易被同种抗体掩盖,本研究试图通过对流式细胞术与传统血清学方法的比较研究,分析两者对自身抗体中混合同种抗体的检测能力差异,为自免溶贫患者输血前检测提供更敏感可靠的方法。方法随机选择使用5例人源抗-D及4例抗-E分别与经验证不具血型特异性的自身抗体按比例梯度混合,配制模拟自免溶贫患者血浆,使用凝胶卡法与流式细胞术分别对上述模拟血浆进行检测。结果三个效价组中（16,32,64）,流式方法可检测出效价为自身抗体1/8~1/16的同种抗体,灵敏度均明显强于凝胶卡方法,且检出下限为凝胶卡方法的4倍（P<0.05）。结论流式细胞术较传统血清学方法对自身抗体掩盖下同种抗体的检测具有更高的灵敏度,采用该方法用于自免溶贫患者输血前检查可降低已有同种抗体介导的输血免疫风险,提高此类患者输血安全。

关键词: 自免溶贫, 自身抗体, 血型同种抗体, 流式细胞术, 血清学方法

Abstract: Objective To compare detection capabilities between flow cytometry and a conventional serological method to develop a more sensitive and reliable technique for clinical pre-transfusion detection of autoimmune hemolytic anemia patients. Methods We used the plasma samples collected from autoimmune hemolytic anemia patients simulated with human-derived autoantibodies and alloantibodies. Common clinically significant antibodies were selected, and 5 cases of anti-D and 4 anti-E were mixed with the autoantibodies in proportion to prepare autoimmune hemolytic anemia patients' plasma samples. The gel card method and flow cytometry were used to detect the above-mentioned simulated plasma, respectively. Results In 3 titer groups (16, 32 and 64), the sensitivity of flow cytometry was significantly stronger than that of the gel card method, and the detection limit was 4 times that of the gel card method (P<0.05). Conclusion Compared with the traditional serological method, flow cytometry has higher sensitivity for the detection of alloantibodies under the cover of autoantibodies. Application of this method for the pre-transfusion examination of autoimmune hemolytic anemia patients can reduce blood transfusion risks mediated by the same antibody and improve the safety of blood transfusion among them.

Key words: Autoimmune hemolytic anemia, Autoantibodies, Blood group alloantibodies, Flow cytometry, Serological methods

中图分类号:

R593.2

赵俸涌, 张玉宇, 王中英, 徐婷, 李勤, 张嘉敏, 向东, 朱自严. 应用流式细胞术对自身免疫性溶血性贫血患者自身抗体掩盖下血型同种抗体检测的研究*[J]. 临床输血与检验, 2022, 24(1): 6-10.

ZHAO Feng-yong, ZHANG Yu-yu, WANG Zhong-ying, et al. Application of Flow Cytometry to the Detection of Blood Group Isoantibodies under the Cover of Autoantibodies in Autoimmune Hemolytic Anemia Patients[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2022, 24(1): 6-10.

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应用流式细胞术对自身免疫性溶血性贫血患者自身抗体掩盖下血型同种抗体检测的研究*

Application of Flow Cytometry to the Detection of Blood Group Isoantibodies under the Cover of Autoantibodies in Autoimmune Hemolytic Anemia Patients

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