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临床输血与检验 ›› 2026, Vol. 28 ›› Issue (3): 369-373.DOI: 10.3969/j.issn.1671-2587.2026.03.012

• 临床输血 • 上一篇    下一篇

不同检测方法与不同酶处理的红细胞对抗-E、抗-c的敏感度分析

林梦霞1, 杨泽文2, 丁教教3, 王海宝1, 向东4   

  1. 1解放军总医院海南医院,海南三亚 572013;
    2上海交通大学医学院附属上海儿童医学中心海南医院,海南三亚 572022;
    3浙江省台州医院,浙江台州 318000;
    4上海市血液中心,上海 200050
  • 收稿日期:2025-07-18 出版日期:2026-06-20 发布日期:2026-07-07
  • 通讯作者: 向东,主要从事输血相容性检测、血型参比相关研究,(E-mail)xiangdong@sbc.org.cn。共同通信作者:王海宝,主要从事临床输血、出凝血管理相关工作,(E-mail)wanghb9839@sina.com。
  • 作者简介:林梦霞,主要从事血小板凋亡研究,(E-mail)116555977@qq.com。并列第一作者:杨泽文,主要从事临床检验与输血工作,(E-mail)862016136@qq.com。

Analysis of the Sensitivity of Red Blood Cells Treated with Different Enzymes to Anti-E and Anti-c Using Various Detection Methods

LIN Mengxia1, YANG Zewen2, DING Jiaojiao3, WANG Haibao1, XIANG Dong4   

  1. 1Hainan Hospital, PLA General Hospital, Sanya, Hainan 572013;
    2Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Hainan Hospital, Sanya, Hainan 572013;
    3Taizhou Hospital, Taizhou, Zhejiang Province 318000;
    4Transfusion Research Institute, Shanghai Blood Center, Shanghai 200050
  • Received:2025-07-18 Online:2026-06-20 Published:2026-07-07

摘要: 目的 鉴于单一检测方法无法检出所有临床显著的红细胞抗体,而酶处理技术和聚乙二醇技术在提升抗体检测灵敏度方面具有独特价值,本研究系统比较四种蛋白酶处理方案联合三种检测方法对抗-E和抗-c抗体的检测效果,为建立优势互补的检测策略提供依据。方法 选取5例不同Rh分型红细胞样本(CcEe型3例、Ccee和CCEe型各1例),使用糜蛋白酶、胰蛋白酶、链霉蛋白酶和木瓜酶对红细胞进行二步酶法处理。酶处理前采用微柱凝胶法(MGT)、聚乙二醇转微柱凝胶法(PEG-MGT)和凝聚胺法(Polybrene)检测抗-E和抗-c抗体效价;细胞经酶处理后统一采用MGT法检测抗体。其中CcEe、CCEe表型细胞检测抗-E;CcEe、Ccee表型细胞检测抗-c。分析酶处理前三种方法差异、四种酶处理后组间差异,以及酶处理后的效价与酶处理前效价的差异。结果 抗-E:酶处理前,三种方法检测效价比较,PEG-MGT与MGT方法比较存在差异(P<0.05);四种酶处理之后,糜蛋白酶与链霉蛋白酶效价存在差异(P<0.05);酶处理后MGT与酶处理前MGT方法效价比较,链霉蛋白酶、木瓜蛋白酶与MGT方法之间效价存在差异(P<0.05)。抗-c:酶处理前,三种方法检测效价比较,Polybrene与MGT比较存在差异(P<0.05);四种酶处理之后,糜蛋白酶与木瓜蛋白酶效价存在差异(P<0.05);酶处理后MGT与酶处理前MGT方法效价比较,胰蛋白酶、链霉蛋白酶和木瓜蛋白酶与MGT方法效价存在差异(P<0.05)。结论 酶处理前,检测抗-E最佳方法是PEG-MGT;检测抗-c最佳方法是Polybrene。酶处理后,链霉蛋白酶-MGT组合是检测抗-E的最佳方案,而木瓜蛋白酶-MGT亦可作为检测抗-c的最佳方案。酶处理技术和PEG可显著提升特定抗体的检测灵敏度,是对常规检测方法的重要补充。

关键词: 蛋白酶, 酶处理红细胞, 抗体效价, 微柱凝胶法, 聚乙二醇转微柱凝胶法, 凝聚胺法

Abstract: Objective This study aimed to investigate the effects of treating red blood cells (RBCs) with four different proteinaases on the detection of anti-E and anti-c antibodies, and to compare the sensitivity among three detection methods. The goal is to provide a scientific basis for selecting the optimal enzyme treatment detection protocol in clinical practice. Methods Five RBC samples with different Rh phenotypes (3 cases of CcEe, 1 case of Ccee, and 1 case of CCEe) were selected. RBCs were treated using a two-step enzyme method with chymotrypsin, trypsin, pronase, and papain. Prior to enzyme treatment, antibody titers for anti-E and anti-c were determined by the Microcolumn Gel Test (MGT), the polybreneethylene Glycol-enhanced Microcolumn Gel Test (PEG-MGT), and the Polybrene method. Following enzyme treatment, the MGT method was used uniformly for antibody detection. Cells with CcEe and CCEe phenotypes were tested for anti-E; cells with CcEe and Ccee phenotypes were tested for anti-c. Analyses were performed on: differences among the three pre-treatment methods; differences among the four enzyme treatment groups; and different titers between post-enzyme treatment and pre-enzyme treatment. Results Anti-E results: Anti-E: Before enzyme treatment, a significant difference in detected titers was found between the PEG-MGT and MGT method (P<0.05). After treatment with the four enzymes, a significant difference in titer was observed between chymotrypsin and pronase (P<0.05). When comparing the titers of MGT after enzyme treatment with those before treatment, significant differences were observed between the pronase and MGT groups, as well as between the papain and MGT groups (P<0.05). Anti-c results: Before enzyme treatment, a significant difference in detected titers was found between the Polybrene and MGT methods (P<0.05). After treatment with the four enzymes, a significant difference in titer was observed between chymotrypsin and papain (P<0.05). When comparing post-enzyme treatment MGT titers with pre-enzyme treatment titers, significant differences were found between the MGT method and the trypsin, pronase, and papain groups (P<0.05). Conclusion Before enzyme treatment, the optimal method for detecting anti-E is PEG-MGT, while the optimal method for detecting anti-c is the Polybrene method. After enzyme treatment, the pronase-MGT combination is the best solution for detecting anti-E, whereas the papain-MGT combination serves as the optimal method for detecting anti-c. Enzyme treatment techniques and PEG can significantly enhance the detection sensitivity of specific antibodies, serving as an important supplement to conventional detection methods.

Key words: Protease, Enzyme-treated red blood cells, Antibody titer, Microcolumn gel test, Polybreneethylene glycol-enhanced microcolumn gel test, Polybrene

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