微柱凝胶免疫对免疫相关性血细胞减少症的诊断价值

目的 探讨骨髓细胞微柱凝胶免疫检测法在免疫相关性血细胞减少症诊断中的敏感性和实用价值.方法 对28例临床疑诊为免疫相关性血细胞减少症的患者进行骨髓单个核细胞直接抗人球蛋白试验(BMMNC-Coombs)和骨髓细胞微柱凝胶免疫法(MGIA)检测自身血细胞抗体.结果 BMMNC-Coombs检出的骨髓造血细胞自身抗体的阳性率为50.0%,骨髓细胞微柱凝胶免疫法检出的阳性率为85.7%,敏感性后者显著高于前者(χ2=8.187,P<0.005).结论 骨髓细胞微柱凝胶免疫法敏感性高于BMMNC-Cooms试验.     

不同免疫抗体检测技术在临床输血中的应用价值

目的探讨不同免疫抗体检测技术在临床输血中的应用价值。方法选取2019年1月至2021年1月在徐州医科大学附属医院需要进行临床输血治疗的1968例患者, 分别采用微柱凝胶抗球蛋白法(microcolum gel Coomb’’s test, MGCT)、凝聚胺法、固相凝集法进行输血前抗体检测, 以谱细胞检测为金标准, 采用kappa一致性检验对比分析三种技术检测的一致性。结果 MGCT和凝聚胺法检测不规则抗体与谱细胞鉴定的一致性Kappa值分别为0.84和0.72。MGCT与凝聚胺法检测不规则抗体效能的特异度及阴性预测值差异均无统计学意义(P>0.05), 而MGCT检测的灵敏度、阳性预测值明显高于凝聚胺法检测, 差异具有统计学意义(81.82%比72.73%, 85.71%比72.73%, χ2值分别为5.01、5.17, P值均<0.05)。MGCT和固相凝集法检测血小板抗体与谱细胞检测一致性的Kappa值分别为0.83和0.75。MGCT与固相凝集法检测血小板抗体效能的特异度及阳性预测值差异均无统计学意义(P>0.05), 而MGCT检测的灵敏度和阴性预测值明显高...     

固相凝集试验检测血小板抗体的临床价值分析

目的对固相凝集试验检测血小板抗体的临床价值进行探讨。方法将我院2012年1月~2013年5月血液科收治的血小板减少患者112例作为临床观察对象并进行回顾性分析,探讨固相凝集试验检测血小板抗体的临床价值。结果本组患者中血小板抗体呈阳性患者共79例,占比为70.53%,其中再生障碍性贫血19例,急性白血病15例,慢性白血病9例,骨髓异常增生6例;另外血小板减少症30例且自身抗体、同种异型抗体以及同种异型抗体与自身抗体时都出现了阳性表现,其他症状均表现为单一同种异型抗体阳性。结论固相凝集试验检测血小板抗体对于血小板减少患者的治疗有着十分重要的意义,可以此分辨患者出现的不同血小板抗原刺激,在诊断治疗中可作为重要临床参考。     

新生儿血小板抗体阳性结果分析

目的 :探讨新生婴儿的血小板抗体阳性是否与临床患者有关系。方法 :用简易致敏红细胞血小板血清学检测技术(SEPSA)对 2 6 6例住院的年龄为 1- 2 0 d的新生儿进行了血小板抗体检测 ,并与同期的 2 782例围产孕妇血小板抗体检测结果进行了对比研究。结果 :显示患病新生儿的血小板抗体阳性率为 11.3% ,显著高于同期围产孕妇的阳性率 (2 .6 % ) ,进而推测高于正常新生儿。新生儿血小板抗体免疫球蛋白类型为 Ig G型。抗体阳性率分布为 :黄疸儿10 .3% ,感染等 16 .7% ,有出血症状的 30 % ,而早产儿是 5 .4 %。结论 :调查的新生婴儿血小板抗体的发生率高与患病有关系孕妇产期作血小板检测具有优生意义 ,能有效地帮助产前诊治 ,减少引发新生儿血小板减少性紫癜及新生儿患病率。     

38840例住院患者血小板抗体筛查分析

目的 通过检测分析血小板抗体在住院患者中的分布特征,探究血小板抗体产生原因,为提高输血质量提供数据支持.方法 选取38840例患者,采用Capture-P固相检测体系检测血小板相关抗体,统计分析抗体阳性率.结果 38840例住院患者中血小板抗体阳性者3989例,阳性率为10.27％.男女性患者阳性率分别为8.7％和11...     

复发性流产患者HLA及血小板特异性糖蛋白抗体GPⅡb/Ⅲa表达的初步研究

目的:探讨原因不明复发性流产(RSA)患者HLA抗体和血小板特异性糖蛋白(GPⅡb/Ⅲa)抗体的表达情况。方法:对299名复发性流产的患者血浆中HLA抗体和GPⅡb/Ⅲa抗体进行检测,血小板抗体检测试剂盒(固相凝集法)筛查IgG抗体,Antigen Tray-LATM板检测HLA抗体,GTI公司PAK-PLUS检测试剂盒检测血小板特异性抗体,利用流式细胞仪技术进行GPⅡb/Ⅲa抗体的确证。结果:检测的299例RSA患者中,IgG抗体阳性26例,阳性率8.69%。26例IgG抗体阳性患者中,25例HLA抗体呈阳性。HLA-Ⅰ类抗体阳性占5.02%,HLA-Ⅱ类抗体阳性占1.33%,HLA-Ⅰ+Ⅱ类抗体阳性占2.01%;在26例RSA患者中,GPⅡb/Ⅲa抗体阳性4例(占15.38%),其中GPⅡb/Ⅲa阳性和HLA抗体均阳性3例(占11.54%),GPⅡb/Ⅲa抗体单独阳性1例(占3.85%)。结论:初步探讨了RSA患者HLA抗体和GPⅡb/Ⅲa抗体的分布情况,本研究为复发性流产患者血小板抗体的检测提供了初步的实验基础。     

免疫性血小板输注无效患者交叉配合输注的研究

目的 通过比较不同血小板输注策略的输注疗效,探讨血小板抗体筛查及交叉配型对于免疫性血小板输注无效(platelet transfusion refractoriness, PTR)患者的应用价值。方法 采用固相凝集法对临床送检血小板抗体筛查的患者进行血小板抗体检测,提取患者的临床资料如性别、年龄、疾病种类、输血记录等,计算血小板抗体筛查阳性率并分析其分布特点。以血小板输注后增量(the post-transfusion platelet increment, PPI)和血小板校正后增值(the corrected count increment, CCI)为衡量指标,分析比较血小板抗体阳性以及不同输血策略(随机输注、交叉相合、交叉不相合)对患者血小板输注疗效的影响。结果 血小板抗体筛查阳性患者61例(23.55%),且多为血液系统疾病患者;其中,抗体筛查阳性组的PPI(U=18 851,P=0.0720)、CCI(U=14 585,P=0.0183)、血小板输注有效率(χ²=5.691,P=0.017)均低于抗体筛查阴性组。61例抗体阳性患者先后共输注122次血小...     

Rh新生儿溶血病21例分析

目的对21例Rh新生儿溶血病血清抗体进行回顾性分析。方法采用盐水试管法检测患儿和母亲ABO及Rh血型,采用直接抗人球蛋白试验、游离抗体试验、放散试验检测患儿新生儿溶血病,采用微柱凝胶间接抗人球蛋白试验对患儿及母亲血清进行不规则抗体鉴定。结果 21例Rh新生儿溶血病中,抗-D引起16例(占76.2%),抗-E引起3例(占14.2%),由抗-E和抗-c联合引起1例(占4.8%),由抗-c引起1例(占4.8%)。结论为预防新生儿溶血病发生,应推广孕妇产前Rh血型及不规则抗体筛查,换血仍是治疗新生儿溶血病主要方法。     

黄疸患儿血清学检测时间对诊断新生儿溶血病的影响

目的对黄疸患儿进行血型血清学检测分析,并探讨血清学检测时间对诊断新生儿溶血病的影响。方法选择2014年1月~5月临床送检母亲为O型、出生1~10d的高胆红素血症黄疸患儿血标本212例,进行患儿红细胞直接抗人球蛋白试验、血清游离抗体试验、红细胞抗体放散试验。结果 212例患儿中,直接抗人球蛋白试验阳性4例(1.9%),游离抗体试验阳性24例(11.3%),放散试验阳性33例(15.6%),未检出ABO以外抗体;出生1~3d、4~7d的新生儿血清学检测阳性率明显高于7d以上的阳性率,放散试验阳性患儿总胆红素明显高于阴性患儿,差异有统计学意义(P0.05)。结论黄疸患儿血清学检测时间与新生儿溶血病检出率密切相关,早期检测,早期确诊,能够为新生儿溶血病的治疗争取时间,对防止胆红素脑病、减低新生儿溶血病后遗症的发生具有重要意义。     

新生儿溶血病ABO血型免疫性抗体检测分析

目的:探讨血型免疫性IgG抗体对母婴ABO血型不合新生儿溶血病的影响.方法:采用抗人球蛋白法、微柱凝胶法对临床有新生儿高胆红素血症的患儿进行血型血清学检测,对母婴ABO血型不合的患儿血标本进行直接抗人球蛋白试验、抗体游离试验和抗体放散试验,检测免疫性IgG抗体的特异性.结果:在476例临床有新生儿高胆红素血症的患儿中,由母婴ABO血型不合引起的新生儿溶血病为59.5%(283/476).其中直接抗人球蛋白试验阳性率为31.4%(89/283),抗体游离试验阳性率为79.5%(225/283),抗体放散试验阳性率为100%(283/283);在283例ABO新生儿溶血病中,由IgG抗A引起者占48.1%(136/283),由IgG抗B引起者占51.9%(147/283).结论:ABO血型为A型或B型的分布与新生儿溶血病的发病率无显著性差异.     

Evaluation of three commercially available rotavirus detection methods for neonatal specimens

Commercially available assay kits have now made detection of rotavirus in stool specimens possible as a routine laboratory test. One such kit, Rotazyme II (Abbott Laboratories, North Chicago, IL) has been reported to give a higher incidence of false positive results with neonatal stool than with stool from older patients. One hundred stool specimens from asymptomatic neonates (age range, two to five days) were tested by two ELISA methods and one latex agglutination method in order to evaluate the rate of false positivity in this group of patients. Negative staining electron microscopy was used as the reference method. The two ELISA methods were Rotazyme II and Rotavirus EIA (International Diagnostic Laboratories, St. Louis, MO), and the latex agglutination method was Meritec-Rotavirus (Meridian Diagnostics, Inc., Cincinnati, OH). The Rotavirus EIA and Meritec-Rotavirus tests gave 0% and 1% false positive results, respectively, while the Rotazyme II test gave a 4% false positive rate with an additional 19% equivocal results. This extensive comparative analysis of commercially available assays for detection of rotavirus in neonatal stool specimens suggests a false positive or equivocal rate with the Rotazyme II test that impairs clinical utility.     

Determination of optimal method for antibody identification in a reference laboratory

Methods commonly used for antibody identification are hemagglutination (tube), column agglutination (gel), and solid-phase red cell adherence. Our AABB immunohematology reference laboratory (IRL) conducted a study to determine which antibody identification testing method was optimal for detecting all clinically significant antibodies. Patient specimens were sent to our IRL from August 2008 to September 2009. Routine testing was performed by tube method and then by manual gel and manual solid-phase methods. Of the 254 samples tested, 115 showed agreement in antibody identification with all three methods. The tube method identified all but six clinically significant antibodies. The gel method did not identify 59 clinically significant antibodies. Fifty-six clinically significant antibodies were not identified by solid-phase testing. Tube testing identified 27 clinically insignificant antibodies, primarily cold autoantibodies. Gel and solid-phase methodologies identified two and three cold autoantibodies, respectively. Solid-phase testing failed to detect 12 examples of anti-K. No identifiable pattern of reactivity was found in 13 samples using gel testing compared with 6 for solid-phase and none for tube methodologies. Hemagglutination tube method was the best choice for our IRL because it missed the fewest number of clinically significant alloantibodies. Benefits also included the ability to use various potentiating factors, incubation times, and temperature phases to enhance antibody identification. The tube method provided critical data for determining antibody clinical significance.     

Sequential study of C reactive protein in neonatal septicaemia using a latex agglutination test.

The usefulness of serial study of C reactive protein in the early detection of neonatal septicaemia was evaluated in a neonatal unit using a commercially available latex agglutination slide test as a rapid screening method and electroimmunoassay as a reference method for C reactive protein determination. A positive latex test was obtained in 11 infants with verified septicaemia (positive blood culture), two infants with clinically evident infection but without bacteriological confirmation, one infant with recurrent chest infection due to Pseudomonas aeruginosa, and one infant who showed signs of birth asphyxia with meconium aspiration, but was not infected. Positive latex test results correlated with raised concentrations of C reactive protein, measured by immunoassay. In some instances, however, concentrations of C reactive protein in excess of 12 mg/100 ml gave weaker agglutination results in the slide test, which could be interpreted as negative results. In a sequential study of the infected infants, 6.3% of the values recorded on a slide test were false negatives. In contrast, false positive values were observed on a slide test in 1.9% of 27 non-infected infants. The higher percentage of false negative values may be due to the presence of excess antigen in the sera of some infected children. It is suggested that the latex test should be carried out on suitable dilutions of serum. Although the slide test may reliably indicate infection at an early stage in neonates, the C reactive protein response is non-specific, as seen in a non-infected infant who showed signs of birth asphyxia with meconium aspiration. Provided the non-specific nature of the C reactive protein response is recognised, the latex test may be a useful serum measurement for early diagnosis of neonatal septicaemia of the newborn. The test has the advantage of being performed easily, quickly, and cheaply.     

Comparison of a latex agglutination test with five other methods for determining the presence of antibody against cytomegalovirus.

A latex agglutination test for determination of antibody against cytomegalovirus was compared with five other methods: a solid-phase fluorescent immunoassay, an indirect hemagglutination test, two solid-phase enzyme immunoassays, and an indirect fluorescent-antibody method, with sera collected from 210 random blood donors. Of the sera tested, 28% were positive for anti-cytomegalovirus by concordance of four or more methods. The latex agglutination test performed well, with a sensitivity of 100%, a specificity of 99%, and positive and negative predictive values of 97 and 100%, respectively. The methods were also evaluated for the number of sera requiring repeat testing, equivocal results after retesting, ease of performance, turnaround time, and technical demands. The tests which best met the requirements for a screening test were the solid-phase fluorescent immunoassay, the indirect hemagglutination test, and the latex agglutination test. The latex agglutination test is a valuable screening tool for detecting total anti-cytomegalovirus which has high sensitivity, high negative predictive value, and rare equivocal results and also has the added advantages of ease of performance and rapid turnaround time.     

人血清布鲁氏菌病两种检测方法比较

目的 对比分析虎红平板凝集实验（RBPT）和试管凝集实验（SAT）两种检测方法的实验结果,为提高布鲁菌病实验室检测水平提供依据。方法 同时采用RBPT和SAT两种方法对2016年1月~2017年12月到锦州市疾控中心布病免疫门诊就诊的高危人群2873份人血清进行布鲁菌病实验室检测,对检测结果进行对比分析。结果 RBPT的阳性率为53.11%（1526/2873）,SAT的阳性率为52.41%（1506/2873）。RBPT与SAT总体阳性进行比较:敏感度为98.47%（1483/1506）,特异性为96.85%（1324/1367）,符合率为97.70%（2807/2873）,两种检测方法符合率很高;RBPT与SAT 1:100++及以上阳性者比较,符合率为72.96%（2096/2873）,两种检测方法符合率不高。结论 RBPT不能代替SAT用于布鲁菌病的临床诊断,对SAT凝集低滴度者应跟踪调查。     

小儿肺炎支原体感染与年龄、性别的关系探讨

目的通过对呼吸道感染患儿血清中肺炎支原体抗体的检测，调查小儿肺炎支原体抗体感染的状况及与患儿性别、年龄的关系。方法采集患儿静脉血、血清做倍比稀释，用日本富士肺炎支原体诊断试剂盒SERODIA-MYCOⅡ做颗粒凝集实验。结果在5155例呼吸道感染患儿中共检出肺炎支原体抗体阳性病例2831例，阳性率为54．9％，男、女患儿阳性率分别为49．6％和63．3％，男女差别具有统计学意义。1岁以内患儿阳性率明显低于其他年龄段，其他年龄段之间阳性率无明显差异；门诊与住院患儿阳性率分别为65．5％和43．2％。结论肺炎支原体感染好发于1岁以上儿童，女童感染机会高于男童，门诊患儿阳性率高于住院患儿。肺炎支原体抗体检测可作为小儿呼吸道感染的常规检测项目。     

Evaluation of latex agglutination test for anti-treponemal antibody in comparison with chemical luminescence tests

The performance of a latex agglutination test (Mediace TPLA) in the detection of anti-treponemal antibody was evaluated in comparison with chemical luminescence tests (LumipulsII-N and Architect TPAb) in 346 cases. Anti-treponemal antibody was further determined by immunochromatography and immunoblotting tests and additionally evaluated by a serological test for syphilis with lipoidal antigens. The total concordance rate between the latex agglutination test and chemical luminescence tests ranged from 96% to 97%: the positive concordance rate ranged from 96% to 97%, and the negative concordance rate, from 97% to 98%. The latex agglutination test showed two false positive cases, and each chemical luminescence test showed two false positive cases, respectively. In eight cases, only the latex agglutination test showed negative results; all specimens contained anti-treponemal antibodies. However, none of these was considered to be a false positive and each was treated as syphilis based on the results of confirmatory analysis with immunochromatography and immunoblotting tests and a serological test for syphilis. The discordant results in the latex agglutination test and chemical luminescence tests may be caused by the different antigenisity of each test. With detailed analysis of those sera treated as syphilis, each specimen was found to contain various antibodies against syphilitic antigens, suggesting that there was a different specificity of native and recombinant antigens. Based on the present results for the comparison between the latex agglutination test and chemical luminescence tests, it was considered that further investigation is necessary to clarify the anti-treponemal antibody profile of syphilis at the disease stage.     

Latex agglutination test for adenovirus diagnosis in diarrheal disease

A commercial latex agglutination test for diagnosis of adenovirus in diarrheal disease (Adenolex, Orion Diagnostica, Finland) was evaluated by comparison with the results obtained by ELISA, electron microscopy (EM), and virus isolation. Fifty specimens originated from the diagnostic routine, and 50 were selected from a previous epidemiological study on the etiology of diarrheal disease in children. Thirteen of the 100 specimens reacted with the latex control, impairing interpretation of the results. Although the ELISA detected adenovirus antigen in 10(2) higher dilutions than the latex agglutination test, a total agreement was obtained between results by the two tests for 87 specimens including 42 positives. The two additional positives found by EM and virus isolation could not be diagnosed by the latex agglutination test. Of 37 specimens containing enteric adenoviruses (types 40 and 41), the agglutination test diagnosed all but 4 specimens containing type 41 virus. These four specimens were negative also by ELISA and adenovirus had been detected by virus isolation on the 293 cell line. The latex agglutination test gave positive results with nine specimens containing adenovirus types other than the enteric types 40 and 41. The latex agglutination test was found to be a rapid and simple method for the detection of adenovirus in diarrheal disease. Compared to ELISA and EM, the sensitivity was 100% and 95% respectively, and the specificity 100%.     

Use of Direct Latex Agglutination Testing of Selective Broth in the Detection of Group B Strepptococcal Carriage in Pregnant Women

Direct latex agglutination testing of selective broth medium for the detection of group B streptococci was evaluated. Results were compared with those obtained by the recommended subculture method. Among the 551 vaginal-rectal specimens tested, 101 (18.3%) were positive by the subculture method. Of these subcultures, latex agglutination testing detected 99 (98%) positive specimens. Agglutination testing of selective broth is a sensitive method which offers the advantage of saving 24 h in the turnaround time for detection of group B streptococci in pregnant women.     

Low positive rate of serum autoantibodies in colorectal cancer patients without systemic rheumatic diseases

Background: Antinuclear antibody (ANA) testing is useful for screening, diagnosis and follow-up of patients with systemic rheumatic diseases. Indirect immunofluorescence (IIF) on HEp-2 cells is the gold standard for ANA testing. However, ANA have also been detected in patients with different cancer types but without any autoimmune disease. To overcome these shortcomings, different automated solid-phase assays have been developed. Aim: To determine the positive rate of a new ANA detection method (EliA CTD Screen, Phadia, Germany), in CRC patients without systemic rheumatic diseases. Additionally, we compare this method with IIF. Materials and methods: Serum samples were obtained before a colonoscopy procedure in a patient cohort (n?=?186) with a high clinical suspicion of CRC. Samples for ANA detection in CRC patients were processed in parallel by IIF on HEp-2 and the solid-phase fluoroenzymeimmunoassay EliA CTD Screen (Phadia, Germany) on the Phadia 250 instrument (Phadia GmbH, Freiburg, Germany). Positive samples by IIF and/or CTD were tested with EliA single ANA assays (Phadia, Germany) on the Phadia 250 instrument (Phadia GmbH, Freiburg, Germany). Results: Forty-five patients diagnosed with CRC were included. Four cases were positive by CTD and 23 by IIF. Of the four positive patients by CTD, two were positive and one indeterminate for anti-dsDNA antibodies. Of the 23 positive by IIF, one patient was positive and another indeterminate for anti-dsDNA antibodies, and a third patient was positive for anti-U1RNP antibodies. Conclusions: The CTD assay shows a low false positive rate for detecting autoantibodies in a clinical context of CRC.