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临床输血与检验

临床输血与检验 ›› 2021, Vol. 23 ›› Issue (5): 617-622.DOI: 10.3969/j.issn.1671-2587.2021.05.015

• 临床输血 • 上一篇    下一篇

国内外抗体鉴定谱细胞抗原谱质量对比分析

陈荣华, 冯文斌, 周清, 李洁, 张雪睿, 兰炯采   

  1. 536000 广西北海市人民医院
  • 收稿日期:2021-03-26 发布日期:2021-10-20
  • 通讯作者: 张雪睿,女,副主任医师,主要从事儿童输血研究,（E-mail）zhxr2007@126.com。共同通信作者：兰炯采,男,研究员,博士研究生导师,主要从事免疫血液学研究,（E-mail）gzlanjc@hotmail.com。
  • 作者简介:陈荣华（1983-）,男,广西北海人,主管技师,本科,主要从事临床输血研究,（E-mail）ipub@163.com。

Comparative Analysis of Cell Antigen Quality of Panel Cells in China and Abroad

CHEN Rong-hua, FENG Wen-bin, ZHOU Qing, et al   

  1. Beihai People's Hospital, Beihai 536000
  • Received:2021-03-26 Published:2021-10-20

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摘要： 目的 分析国内市场上常见的国产与进口抗体鉴定用谱红细胞（以下简称谱细胞）,研究对比其抗原格局、抗原覆盖面、分析判定鉴定结果的注意事项。方法 收集国内市场上采用的国产谱细胞20个批次（G1~G20）与进口谱细胞11个批次（J1~J11）,从抗原组成格局、抗原覆盖率、抗原阴阳性比例和是否纯合子等多项指标进行质量评价,用Fisher四格表资料的确切概率法进行抗原可靠性分析。结果 国产谱细胞20个批次共覆盖29种抗原,覆盖率为76.00%±34.3%,进口谱细胞11个批次共覆盖28种抗原,覆盖率为83.00%±21.9%。比较两组谱细胞,进口谱细胞缺乏抗原：Mur、Dia、Dib、Doa、Dob、Yta、Ytb,国产谱细胞缺乏抗原：Cw、V、f、Jsa、Jsb、Xga;国产谱细胞20个批次鉴定不规则抗体的不可靠抗原比例为49.16%±7.78%,进口谱细胞11个批次比例为27.61%±5.48%;国产谱细胞中12种纯合子抗原占比70.50%±4.62%,进口谱细胞中12种纯合子占比为73.15%±4.59%。结论 国产谱细胞的抗原覆盖率与进口谱细胞相差不大,而抗体鉴定的可靠性低于进口谱细胞,应增加谱细胞份数或改变抗原组成格局以提高不规则抗体鉴定的可靠性。进口谱细胞未包含Dia抗原和Mur抗原等中国汉族人群中频率特有的抗原,并不适用于中国汉族人群。由于血型抗原具有民族多态性和地域多态性,不规则抗体分布也具有民族多态性和地域多态性,建议根据民族集居的地区设计适用于筛查该民族不规则抗体的谱细胞,在临床安全有效输血和预防新生儿溶血病中发挥更大的作用。

关键词: 红细胞血型, 抗体鉴定谱细胞, 不规则抗体

Abstract: Objective To analysis the common panel cells for antibody identification in the domestic market, to study the antigen pattern, antigen coverage, and matters needing attention in analyzing and judging the identification results. Methods 20 batches of domestic panel cells (G1~G20) and 11 batches of imported panel cells (J1~J11) were collected for quality evaluation from the aspects of antigen composition pattern, antigen coverage rate, antigen negative and positive ratio and homozygote or not. The reliability of antigen was analyzed by Fisher's exact test. Results 20 batches of domestic cells were covered with 29 antigens, the coverage rate was 76.00%±34.3%, and 11 batches of imported cells were covered with 28 antigens, the coverage rate was 83.00%±21.9%. Compared the two groups of panel cells, the imported panel cells lack antigens: Mur、Dia、Dib、Doa、Dob、Yta、Ytb; the domestic panel cells lack antigens: Cw、V、f、Jsa、Jsb、Xga; the unreliable antigen ratio of 20 batches of domestic panel cells in identifying irregular antibodies is 49.16%±7.78%, and that of 11 batches of imported panel cells is 27.61%±5.48%.The proportion of homozygotes in imported cells was 73.15%±4.59%. Conclusion The antigen coverage of domestic panel cells is similar to that of imported panel cells, but the reliability of antibody identification is significantly lower than that of imported panel cells. It is necessary to increase the number of panel cells or change the pattern of antigen composition to improve the reliability of irregular antibody identification. The imported panel cells do not contain Dia antigen, Mur antigen and other antigens with high frequency in Chinese Han population, so they are not suitable for Chinese Han population. Because blood group antigens have ethnic and regional polymorphism, and irregular antibody distribution also has ethnic and regional polymorphism, it is suggested to design panel cells suitable for screening irregular antibody according to the ethnic concentrated areas, so as to play a greater role in clinical safe and effective blood transfusion and prevention of hemolytic disease of fetus and newborn.

Key words: Red blood cell group, Panel cells, Irregular antibody

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