两种方法检测孕妇IgG抗A(B)的比较分析

目的 比较分析抗人球蛋白微柱凝胶法与传统试管法测定O型孕妇血清中IgG抗A(B)效价的方法学差异.方法 采用微柱凝胶抗人球方法和经典抗人球蛋白试验平行检测122例与丈夫ABO血型不合的O型孕妇血清IgG抗A(B)水平,并作方法学评价.结果 1 22例分析样本中.微柱凝胶法检测结果＜1:64的30例样本经试管法测定结果全部一致;微柱凝胶法检测结果≥1:64的92例样本中,经试管法测定有33例结果为＜1:64.经卡方检验,两种方法的差异有统计学意义(P＜0.01).结论 凝胶微柱法比传统试管法具有更高的灵敏度,判读更为准确,但高灵敏度并不意味着更高的HDN诊断效率,连续监测孕妇血清lgG抗A(B)水平和多种临床指征的综合分析是十分必要的.     

微柱凝胶技术测定孕妇IgG抗A(B)效价分析

目的分析抗人球蛋白微柱凝胶技术在测定O型孕妇血清IgG抗A(B)效价的方法学应用。方法应用微柱凝胶技术测定220例O型孕妇血清IgG抗A(B)效价,并对结果进行分析。结果 220例O型孕妇血清IgG抗体效价检测,IgG抗体效价大于或等于1∶64者共77例,其中O-A型夫妇IgG抗A效价大于或等于1∶64者28例,O-B型夫妇IgG抗B效价大于或等于1∶64者39例,O-AB型夫妇IgG抗A(B)效价均大于或等于1∶64者10例。结论微柱凝胶法检测O型孕妇血清IgG抗A(B)效价可有效地预防因母婴ABO血型不合引起的新生儿溶血病的发生,对优生优育具有重要的临床意义。     

抗人球蛋白微柱凝胶法和试管法检测孕妇lgG抗A(B)的比较

目的比较抗人球蛋白微柱凝胶法和传统试管法检测O型孕妇血清中ABO血型免疫性抗体的滴度差异及方法的灵敏度。方法用抗人球蛋白微柱凝胶法和传统试管法平行检测53例与丈夫ABO血型不合的O型孕妇血清IgG抗A(B)水平,经配对t检验,比较两种方法检测结果的差异。结果微柱凝胶法及试管法检测的平均抗体滴度分别是1:160和1:45,前者比后者高3．56倍,两法差异非常显著(P<0．001),但检测结果有相关性(r=0．829,P<0．001)。另外,以微柱凝胶法检测398例O型孕妇,抗体滴度1:64以上所占的孕妇比率显著高于以试管法检测的文献报道结果。结论微柱凝胶法比试管法具有更高的灵敏度,且实验操作简便、快速,更适合于广泛应用,但因灵敏度过高,需对其决定值进行界定。     

微柱凝胶法检测O型孕妇IgG抗体效价结果分析

目的 探讨微柱凝胶法在产前血型血清学检查和预防新生儿溶血病的应用价值.方法 用微柱凝胶法检测96例O型孕妇ABO-IgG抗体效价,并与临床传统试管法抗人球蛋白法进行比较.结果 两种方法检测结果一致者8例,占总数8.33％,比较差异无统计学意义(P＞0.05);微柱凝胶法比传统抗人球蛋白法判读结果高2个等倍稀释度有7例,占总数7.29％,比较差异无统计学意义(P＞0.05);微柱凝胶法比传统抗人球蛋白法判读结果高1个等倍稀释度有81例,占总数84.3％,比较差异有统计学意义(P＜0.05);IgG抗A(抗B)效价≥128有47例,占48.9％,O-A＞O-B＞O-AB妇一夫组合.结论 产前血型血清学检查十分必要,微柱凝胶法比传统抗人球蛋白法操作更简便、快捷、具有更高的灵敏度.     

两种方法测定孕妇IgG类血型抗体效价比较分析

在含有抗人球蛋白抗体IgG的特定凝胶基质中结合发生的特异性细胞凝集反应原理,能快速筛查红细胞表面致敏抗体或血清中IgG抗体,是一种改良的抗人球蛋白实验(DAT)。本文通过孕妇产前夫妇双方ABO血型和Rh血型鉴定,孕妇血液不规则抗体筛查,用试管法及微柱凝胶卡技术两种方法同时对孕妇血液IgG类抗体效价测定。结果 340例ABO血型不合夫妇血型组合分布,340例微柱凝胶卡孕妇IgG类血IgG型抗体效价测定结果比较,两种检测方法结果有显著差异。     

探讨微柱凝胶法在检测孕妇ABO血型IgG抗体效价中的应用

目的初步探讨微柱凝胶法技术在检测O型血孕妇血清中IgG抗A（B）血型抗体水平中的应用价值,以预防新生儿溶血病的发生。方法应用微柱凝胶法技术和抗球蛋白法分别测定O型血孕妇IgG抗A（B）抗体效价。结果 1 798例夫妻中,微柱凝胶法和抗球蛋白法检测O-A组合IgG抗A效价≥1∶64者分别为53例、51例;O-B组合IgG抗B效价≥1∶64者分别为32例、29例;O-AB组合IgG抗A抗B效价均≥1∶64者分别为6例、7例,2种方法差异无统计学意义（P〉0.05）。结论微柱凝胶免疫检测法可快捷准确检测O型血孕妇血清IgG抗A（B）抗体的效价,对预防新生儿溶血病的发生具有重要临床意义。     

2种方法检测孕妇免疫球蛋白G抗-A(B)效价的对比研究

目的探讨微柱凝胶法和抗人球蛋白试管法检测O型孕妇血清免疫球蛋白G(IgG)抗-A(B)效价的差异及相关性。方法采用微柱凝胶法和抗人球蛋白试管法同时检测133例O型孕妇血清IgG抗-A(B)水平,并比较2种方法的检测结果。结果 2种检测方法结果呈高度相关。若以凝集强度1+为判定终点,微柱凝胶法比抗人球蛋白试管法检测结果高出2个稀释倍数;微柱凝胶法以256作为临床参考值,试管法以64作为临床参考值,2种方法阳性检出率差异无统计学意义(P0.05)。若微柱凝胶法以凝集强度3+为判定终点,试管法以1+为判定终点,2种方法检测结果差异无统计学意义(P0.05)。结论 2种检测方法的一致性较好,微柱凝胶法的灵敏度高于抗人球蛋白试管法。若以凝集强度1+为判定终点,推荐微柱凝胶法正常参考值为小于256;若以凝集强度3+为判定终点正常参考值为小于64。     

3种方法检测O型血孕妇IgG血型抗体效价分析

目的应用微柱凝胶试剂卡、微柱玻璃珠试剂卡、经典试管法同时检测夫妇ABO血型不合的O型孕妇IgG血型抗体效价,探讨微柱凝胶试剂卡、微柱玻璃珠试剂卡检测孕妇血型抗体效价的界值。方法用微柱凝胶试剂卡、微柱玻璃珠试剂卡、经典试管法平行检测O型血孕妇Ig G血型抗体效价。结果微柱凝胶试剂卡、微柱玻璃珠试剂卡以1∶128为界值与试管法1∶64比较,阳性检出率差异无统计学意义(P0.05)。结论使用微柱凝胶试剂卡、微柱玻璃珠试剂卡检测O型孕妇IgG血型抗体效价的临床参考值应设为≥1∶128。     

微柱凝胶技术在输血相关试验中的评价及应用研究

目的 探讨微柱凝胶技术在血型鉴定、交叉配血、抗体效价测定等相关输血试验中的应用,并对其进行方法学评价.方法 对微柱凝胶技术测定的55例Rh D阴性患者中的15例抗-Rh D呈阳性血样及21例正、反定型不符血样、29例交叉配血不合血样综合分析,并与试管抗人球蛋白结果对比.同时,对微柱凝胶技术检测的853例O型孕妇IgG型抗-A或抗-B效价结果进行分析.结果 抗-Rh D的检出率显示,微柱凝胶技术为27.27%(15/55),试管法为21.82%(12/55),效价在1:4以上阳性标本的检出两种方法一致.21例正、反定型不符的标本中,抗原或抗体减弱的11例用微柱凝胶技术检测,显示出反应的不一致性;而用试管法则呈现弱阳性反应.交叉配血中,微柱凝胶技术检出的29例阳性用试管法证实,2例为假阳性.O型孕妇血型效价测定以1:128为界,配偶为A型时,检出率为33.18%(144/434);配偶为B型时,检出率为33.17%(139/419),两者无显著差异.结论 微柱凝胶技术有操作简便、快速、结果客观的优点,但应重视其假阳性和假阴性.出现异常结果时,应将传统的试管法结合显微镜镜检.     

新生儿ABO溶血病血清学检测方法比较与结果分析

目的 采用微柱凝胶技术以及经典抗人球试验进行新生儿ABO溶血病血型血清学检测,以提高早期诊断水平.方法 对1 627例新生儿进行血型血清学分析包括:母婴血型、直接抗人球蛋白试验、血清游离抗体试验、红细胞抗体放散及测定试验、ABO血型系统以外的抗体鉴定试验.结果 1 627例病例中确诊为ABO-HDN的有163例,其中母-婴血型为O-A及O-B的最多,共占97.55%.确诊为HDN血清学结果 中放散试验和游离抗体试验同时阳性最多,占76.07%.诊断为HDN可疑病例血清学结果 中,直接抗人球蛋白试验阳性率最多,占79.55%.在出生后3～7天内确诊ABO-HND的患儿教最多,占66.26%.微柱凝胶技术以及经典抗人球试验镜下结果 完全相符.结论 红细胞抗体释放试验,直接抗人球蛋白试验和血清游离抗体试验是早期诊断ABO-HDN的有效方法 .ABO-HDN检出率与所采用的实验方法 ,采血时机有很大关系.     

Comparative evaluation of the microcolumn gel card test and the conventional tube test for measurement of titres of immunoglobulin G antibodies to blood group A and blood group B

The conventional tube test (CTT) and microcolumn gel card test (MG) were used to measure immunoglobulin G (IgG) antibody titres to blood group A (anti-A) and blood group B (anti-B) in 288 serum samples. Diagnostic concordance and correlations between the two methods were analysed. MG was more sensitive than CTT in the detection of both anti-A and anti-B IgG. Correlation coefficients for the two methods for the titration of anti-A and anti-B were 0.8470 and 0.8336, respectively. The regression equation representing the relationship between the two methods was calculated and used to convert critical values for anti-A and anti-B IgG antibodies determined by CTT to critical values for MG titration. Analyses showed 86.8% and 89.9% diagnostic concordant rates for the detection of anti-A and anti-B IgG, respectively. It was concluded that titration results obtained by MG correlate well with those obtained by CTT, but critical values determined by CTT need to be converted into corresponding MG values.     

Comparison of a gel microcolumn assay with the conventional tube test for red blood cell alloantibody titration

BACKGROUND: Titration is a semiquantitative method used to estimate red blood cell (RBC) alloantibody reactivity. The conventional tube test (CTT) technique is the traditional method for performing titration studies. The gel microcolumn assay (GMA) is also a sensitive method to detect RBC alloantibodies. The aim of this study was to compare a GMA with the CTT technique in the performance of Rh and K alloantibody titration. STUDY DESIGN AND METHODS: Patient serum samples that contained an RBC alloantibody with a singular specificity were identified by routine blood bank workflow. Parallel titration studies were performed on these samples by both the CTT method and a GMA (ID‐Micro Typing System anti‐IgG gel card, Micro Typing Systems, Inc., an Ortho‐Clinical Diagnostics Company). RESULTS: Forty‐eight samples were included, including 11 anti‐D, five anti‐c, 13 anti‐E, one anti‐C, three anti‐e, and 15 anti‐K. Overall, the two methods generated identical results in 21 of 48 samples. For 42 samples (87.5%) the two methods generated results that were within one serial dilution, and for the remaining six samples, results were within two dilutions. CONCLUSION: GMA systems may perform comparably to the CTT in titrating alloantibodies to Rh and Kell antigens.     

孕妇血清IgG抗A（B）抗体效价微柱凝胶法室内参考值测定

目的通过比较微柱凝胶法和传统抗人球蛋白试管法检测孕妇血清中IgG抗A（B）抗体效价的差异。以评价微柱凝胶法的灵敏度,得出本实验室微柱凝胶法的室内参考值。方法用微柱凝胶法和传统试管法平行检测3782例孕妇血清IgG抗A（B）抗体,比较两种方法检测结果的差异。结果微柱凝胶法和传统试管法检测孕妇血清IgG抗A（B）抗体效价均值分别为92．79、30．65,前者是后者的3．03倍;微柱凝胶法检测IgG抗A（B）阳性率明显高于传统试管法;微柱凝胶法的1：256与传统试管法的1：64作为本室的室内参考值意义相同。结论微柱凝胶法检测孕妇血清中IgG抗A（B）抗体效价的室内参考值应设为1：256;该方法灵敏度高于传统试管法。     

Use of gel microcolumn assay for the detection of drug-induced positive direct antiglobulin tests

Drugs can result in broad variety of hematologic abnormalities including positive direct antiglobulin test. In this study, we evaluated gel microcolumn assay for the detection of drug-induced antibodies. Direct antiglobulin test was performed by conventional tube and by gel microcolumn assay in 139 hospitalized patients. Drug in vitro studies were done in 34 patients with positive direct antiglobulin test by tube test and gel microcolumn assay using serum and eluate. None of them had signs of hemolytic anemia. A total of 1,000 blood samples from donors were used as control group. Gel microcolumn assay was more sensitive than in tube test for direct antiglobulin test (P<0.01). Positive direct antiglobulin test was more frequent in patients than in donors (P<0.01). Drug in vitro studies were positive with at least one drug in 76.5% of patients with positive direct antiglobulin test by immune complex and/or adsorption mechanisms. We found a high incidence of positive drug in vitro tests in positive direct antiglobulin test patients. Gel microcolumn assay showed appropriate results for drug in vitro studies. The combination of tube and gel microcolumn assay can improve detection of drug-induced positive direct antiglobulin tests.     

两种方法测定孕妇 IgG 型抗-A（B）效价的比较

目的：对微柱凝胶技术和流式细胞术两种检测 IgG 型抗 ABO 抗体的方法进行比较。方法以 O 型孕妇为实验组, A/B 型孕妇作为对照组,分别用微柱凝胶技术和流式细胞术检测 IgG 型抗 ABO 抗体,分析实验组和对照间阳性率的差别以及两种方法间相关性。选取不同滴度样品在不同日期进行检测以比较两种方法的重复性。结果共收集实验组300例,对照组300例。微柱凝胶技术和流式细胞的检测结果表明,实验组阳性率高于对照组,差异有统计学意义（P ＜0．05）。微柱凝胶检测和流式细胞术检测相关系数 rs ＝0．694。微柱凝胶技术检测的变异系数小于流式细胞检测变异系数（P ＜0．05）。结论 ABO 血型不合多见于 O 型孕妇,流式细胞检测与微柱凝胶技术具有很好的相关性,流式细胞术重复性好于微柱凝胶技术。     

IMMUNOHEMATOLOGY: Streamlining ABO antibody titrations for monitoring ABO‐incompatible kidney transplants

BACKGROUND: We have monitored ABO antibody titers in 53 ABO‐incompatible kidney transplants (INKTs) using a time‐consuming, conventional test tube (CTT) method that included a 30‐minute room temperature (RT) phase, followed by incubation for 30 minutes at 37°C and conversion to the anti‐human globulin (AHG) phase. Our studies have indicated that AHG ABO antibody titers are critical for clinical management, but RT titers do not supplement clinical decision making. Therefore, we assessed AHG titers by two methods: 1) a revised test tube (TT) method without RT and 2) an anti‐immunoglobulin G (IgG) gel microcolumn (IgG gel) method with a goal of streamlining ABO antibody titrations. STUDY DESIGN AND METHODS: Fifty frozen samples from our INKT collection with anti‐A and/or anti‐B AHG titers of 2 to 512 were titrated by revised TT method with 30 minutes at 37°C and conversion to AHG and by IgG gel method with 15 minutes at 37°C and centrifugation. RESULTS: The titers using the revised TT and IgG gel methods had 64 and 52% concordance, respectively, with CTT AHG titers. Neither the revised TT AHG titers nor the IgG gel titers varied by more than one standard dilution from the CTT AHG titers, which is within acceptable limits for titration techniques. CONCLUSIONS: The revised TT and IgG gel titers are comparable to the CTT AHG titers. The IgG gel method offers the best titer turnaround time, eliminating 45 minutes of incubation time alone. Implementation of this technique would benefit ABO INKT patients by providing titer results in a more timely manner.     

微柱凝胶技术在输血相关试验中的评价及应用研究

目的探讨微柱凝胶技术在血型鉴定、交叉配血、抗体效价测定等相关输血试验中的应用,并对其进行方法学评价。方法对微柱凝胶技术测定的55例RhD阴性患者中的15例抗-RhD呈阳性血样及21例正、反定型不符血样、29例交叉配血不合血样综合分析,并与试管抗人球蛋白结果对比。同时,对微柱凝胶技术检测的853例0型孕妇IgG型抗-A或抗-B效价结果进行分析。结果抗-RhD的检出率显示,微柱凝胶技术为27．27％（15／55）,试管法为21．82％（12／55）,效价在1：4以上阳性标本的检出两种方法一致。21例正、反定型不符的标本中,抗原或抗体减弱的11例用微柱凝胶技术检测,显示出反应的不一致性;而用试管法则呈现弱阳性反应。交叉配血中,微柱凝胶技术检出的29例阳性用试管法证实,2例为假阳性。O型孕妇血型效价测定以1：128为界,配偶为A型时,检出率为33．18％（144／434）;配偶为B型时,检出率为33．17％（139／419）,两者无显著差异。结论微柱凝胶技术有操作简便、快速、结果客观的优点,但应重视其假阳性和假阴性。出现异常结果时,应将传统的试管法结合显微镜镜检。     

孕妇产前IgG血型抗体效价测定及临床应用

目的观察孕妇产前体内IgG血型抗体水平及与新生儿溶血病的关系。方法采用微柱凝胶抗人球蛋白卡法对255例夫妇进行产前IgG血型抗体效价及ABO血型测定。结果在对195例夫妇ABO血型不合调查中,IgG血型抗体水平异常(≥64)阳性率为93.8%。其中IgG抗A(B)效价:64为12例(6.2%),64为12例(6.2%),128为60例(30.8%),256为39例(20%),512为45例(23.0%),1 024为27例(13.8%)。丈夫/孕妇血型组合为A/O与丈夫/孕妇血型组合为B/O两组间IgG抗体检出率比较,差异无统计学意义(χ2=4.361,P=0.499),AB血型的父亲其妻子抗体效价更高。结论对夫妇ABO血型不合孕妇产前IgG血型抗体效价测定有助于新生儿溶血病的产前预测,以利于尽早采取有效预防、治疗,减少新生儿溶血病的发病率,对于人口优生方面具有重要意义。