三种红细胞不规则抗体筛选试验方法的比较

目的寻找简便、快速、敏感的红细胞不规则抗体筛选的试验方法。方法采用蛋白水解酶法、抗球蛋白法(AGT)及聚凝胺三步法试验(TSPT)平行检测一批Rh、MNSs、Duffy、K idd等系统的不规则抗体效价,观察TSPT等的敏感性。结果在上述3种方法中,TSPT敏感性最高,其次为AGT,TSPT测出了所有IgG和IgM性质的不规则抗体,酶技术未检出抗-M、N、S、s、Fya、Fyb,TSPT和AGT的试剂性能稳定。结论TSPT操作简便迅速,敏感性高,无需特殊设备,TSPT适用于红细胞血型不规则抗体筛选的常规试验。     

自动化微量板法检测红细胞不规则抗体的研究

目的利用自动化设备寻找一种简便快速的献血者红细胞不规则抗体(RBC-IAb)筛选方法。方法采用微量板聚凝胺三步法试验(TSPT)、菠萝酶法、抗人球蛋白法(AGT)及经典试管TSPT,平行检测一批Rh等抗体效价,选出最佳的筛查方法,并观察抗凝剂、溶血、脂血对实验的影响。结果在上述四种方法中,以微量板TSPT作为筛检最佳,对14 210名献血者进行了RBC-IAb筛查,发现40例阳性,最多为抗-Mur 15例。结论微量板TSPT筛查献血者RBC-IAb,操作简便迅速,敏感性高,可在自动化加样仪中使用,并能与酶标仪和计算机相结合,尤其适合大批标本筛查。     

四种检测红细胞血型IgG抗体方法的比较

目前医院常规交叉配血一般用盐水法，但盐水交配不能检出免疫性ＩｇＧ抗体，因而有输血反应的危险。而检测红细胞血型ＩｇＧ抗体所用酶法，抗球蛋白法由于步骤多、时间长及试剂、仪器等因素不适合常规及急诊配血。Ｐｏｌｙｂｒｅｎｅ法（聚凝胺）能快速、灵敏地检测ＩｇＧ...     

红细胞不规则抗体检查技术的探讨

<正> 红细胞不规则抗体的检测方法,被广泛应用于预防输血反应及诊断母婴血型不配合妊娠所致的新生儿溶血病.本文对目前常用的红细胞不规则抗体检查的各种血清学技术进行了探讨,以供血型工作者们参考应用.     

红细胞血型不规则抗体17例分析

目的检测住院患者红细胞血型不规则抗体确保输血安全。方法以凝聚胺法配血用于检测红细胞不规则抗体。结果苏大附二院自1996年以来,共发现红细胞不规则抗体17例,分别为抗E8例,抗-cE3例,抗D2例,抗c1例,疑抗-Le~b1例,抗M2例。结论对住院患者常规检测红细胞抗体有利于保障输血的安全、有效和及时,避免免疫溶血性输血反应的发生。     

聚凝胺试验用于致敏红细胞和不完全抗体初筛的探讨

目的：探索MPT用于致敏红细胞和不完全抗体初筛的可能性。方法：设计了用MPT测定致敏红细胞的方法，即先吸取3％～5％的待检红细胞悬液2滴和健康献血员AB型血浆(血清)1滴混合，AB型血浆作为一种抗红细胞“粘壁”现象的惰性介质；设计了用MPT测定血清中有无不完全抗体的方法，即先吸取待检血清2滴加入3%～5%的Rh(D)阳性混合健康献血员O型红细胞悬液1滴，O型红细胞作为检测不完全抗体是否存在的栽体；接下去按一般的MPT步骤操作。通过模拟试验和临床应用来论证MPT的这一新用途。结果多量蛋白质的存在不影响MPT结果，蛋白质过少会导致MPT中红细胞“粘壁”现象，通过加入适量血浆(血清)能消除；MPT能检测最高稀释度为1：256的抗D(IgG)和1：64的免疫性抗A血清制备的模拟致敏红细胞和不完全抗体。MPT检测凝胶法抗球蛋白试验阳性15例，MPT结果比试管法敏感，和凝胶法一致；检测试管法阴性20例临床标本，MPT结果与试管法符合。结论：MPT可用于致敏红细胞和相应不完全抗体的初筛，比试管法抗球蛋白试验敏感、快捷。     

卡式微柱凝胶技术与聚凝胺法在血型鉴定及输血前红细胞不规则抗体检验中的应用效果比较

目的探讨卡式微柱凝胶技术与聚凝胺法在血型鉴定及输血前红细胞不规则抗体检验中的应用效果。方法选择2018年3月至2019年3月于南阳市第二人民医院接受检验的输血患者584例,均进行聚凝胺法检验与卡式微柱凝胶技术检验。对比两种检验方法不规则抗体检出情况、ABO及Rh(D)血型的鉴定准确率。结果在584例输血患者中,卡式微柱凝胶技术检出21例阳性,阳性率为3. 60%(21/584),聚凝胺法检出10例阳性,阳性率为1. 71%(10/584),卡式微柱凝胶技术阳性率较高,差异有统计学意义(P 0. 05);聚凝胺法检验ABO血型鉴定准确率为97. 77%、Rh(D)血型鉴定准确率为97. 95%,卡式微柱凝胶技术ABO血型鉴定准确率为99. 66%、Rh(D)血型鉴定准确率为99. 83%。结论卡式微柱凝胶技术相较聚凝胺法在血型鉴定及输血前红细胞不规则抗体检验中,灵敏度较高,判断血型准确率较高,加强不规则抗体筛选,利于提高输血安全性,效果较显著,值得推广。     

2638名患者红细胞血型不规则抗体调查

目的研究孝感地区住院患者中红细胞血型不规则抗体的发生频率和分布特点。方法采用常规血型血清学试验方法,对不规则抗体筛选和免疫球蛋白类型鉴定。结果红细胞血型不规则抗体的检出率为0.80%,确认抗体特异性18例(85.71%);自身抗体3例(14.29%)。其中抗-D1例(4.76%);抗-C2例(9.52%);抗-c4例(19.05%);抗-E4例(19.05%);抗-M2例(9.52%);抗-N1例(4.76%);抗-P12例(9.52%);抗-Lea2例(9.52%)。免疫球蛋白类别为IgM抗体4例占19.05%;IgG抗体14例占66.67%;IgM+IgG抗体3例占14.29%。结论本文筛选的红细胞血型不规则抗体的发生频率和分布特点与文献报道(0.3%—2.0%)基本相符合;同时提示女性患者不规则抗体的发生频率高于男性。     

红细胞磁化技术用于献血者不规则抗体筛查的试验研究

目的探讨红细胞磁化技术(EMT)用于献血者不规则抗体筛查的可行性。方法采用基于EMT的柯利斯全自动血型系统结合间接抗人球蛋白试验对上海地区4 995例献血者标本进行不规则抗体筛查,并与微孔板木瓜酶法作比对试验。结果柯利斯系统初筛反应性22例(4.4‰),微孔板木瓜酶法初筛反应性53例(10.6‰),经参比实验室确认阳性为10例。结论基于EMT的柯利斯全自动血型系统作不规则抗体筛查,具有操作方便、灵敏度高、结果准确、完全溯源等特点。     

36287名患者红细胞不规则抗体特异性及其分布

目的对本院住院患者红细胞不规则抗体特异性进行分析,为临床疑难输血提供依据。方法收集整理2006年6月-2013年5月本院住院患者不规则抗体筛查及相关抗体鉴定资料,分析不规则抗体阳性检出率及人群特征。结果本组患者血液标本共计362 87例,抗体筛选阳性571例,阳性率1.574%(571/36 287)。鉴定出特异性抗体312例,阳性率0.860%(312/36 287);自身抗体259例,阳性率0.714%(259/36 287);直接抗球蛋白阳性284例,阳性率0.78%。同种特异性抗体,230例Rh系统抗体所占构成比最高,为73.72%(230/312),阳性率为0.634%;其中抗-E阳性共191例,占61.22%(191/312),阳性率为0.526%;Lewis系统36例,占11.54%(36/312),阳性率为0.099%;MNSs系统34例,占10.89%(34/312),阳性率为0.094%。女性不规则抗体阳性率显著高于男性(P0.001),有妊娠输血史者的检出率显著高于无妊娠、输血史者(P0.05),血液病患者产生不规则抗体居首位。结论住院患者输血前进行不规则抗体筛查,可避免免疫性溶血性输血反应的发生,尤其是对女性,及有妊娠史、输血史患者具有重要意义。     

长治地区红细胞不规则抗体筛选细胞的建立

目的 对200例O型献血者进行稀有血型抗原鉴定与筛选,建立适用于本地区的抗体筛选细胞.方法 对所有标本进行ABO血型、稀有血型抗原的检测,根据筛查的结果,选出2～3份抗原表位广,而且通过互补覆盖长治地区可能出现的稀有血型抗原的O细胞组成抗体筛选细胞.结果 本次共制备2组筛选细胞,均覆盖了D、C、E、c、e、JKa、JKb、M、N S、s、、Fya、ryb、k、lea、Leb、P1、Lub等抗原.结论 本次制备的抗体筛选细胞不仅覆盖了长治地区可能出现的抗原,而且与商业筛选细胞相比有漏检抗体少、不易漏检低效价抗体等特点,更适合用于长治地区抗体筛选.     

Comparison of three methods for detecting antibody to cytomegalovirus

To determine the availability of cytomegalic inclusion virus (CMV) antibody-negative blood among our local donor population, 1384 consecutive group O donors were tested for CMV antibody by the indirect hemagglutination assay (IHA); 51 percent (711) were seronegative (titer less than 8). The highest percentage of seronegative findings (60%) was among donors 18 to 35 years old. This age group represented 57 percent of the donors. IHA, enzyme immunoassay (EIA), and passive latex agglutination (PLA) methods were compared on 491 donor samples. The reference method was the anticomplement immunofluorescence test. Sensitivities were: IHA, 89 percent; EIA, 93 percent; and PLA, 90 percent. Specificities were: IHA, 90 percent; EIA, 95 percent; and PLA, 100 percent. All but two of the false-negative samples contained antibody at low titer (less than or equal to 10), which is of doubtful significance relative to transfusion-transmitted CMV infections. All three methods were suitable for screening blood donors. The PLA was easy to perform and had a short processing time that would allow rapid assay of fresh (less than 7 days old) untested blood at the time of selection for transfusion. Thus, both the amount of pretested blood kept in stock and the cost of obtaining each CMV-seronegative unit could be reduced.     

红细胞血型系统IgG型不规则抗体固相凝集法检测试剂盒的研发

目的研发基于固相凝集技术的红细胞血型系统IgG型不规则抗体检测试剂盒并评估其性能。方法采用单克隆抗人-RBC抗体包被96孔微板,按100μL/孔加入红细胞悬液形成细胞单层,经过裂解后形成红细胞膜抗原分子单层,加入保护液冷冻干燥后制备成检测用的反应微板;用梯度倍比稀释的多克隆羊抗球蛋白试剂(IgG+C3d/4)与IgG抗-D致敏的O型红细胞反应,筛选构建最佳指示系统;用不同批次的试剂盒检测低效价的IgG抗-D和抗-E,评估试剂盒在保存期内的抗原稳定性;与微柱凝胶抗球蛋白卡、进口同类试剂盒检测不同效价的抗体以测试3者的灵敏度;与进口同类试剂盒对350例血样标本进行检测,以明确2者的检测效能是否一致。结果 20μg/mL的抗人-RBC抗体溶液能够很好的固定红细胞膜抗原分子单层;稀释16倍的多克隆羊抗球蛋白试剂与致敏红细胞构建的指示系统指示效果最佳;试剂盒中冻干的红细胞膜抗原在6个月的保存期内保持稳定;本研究的试剂盒检测灵敏度高于Capture-R Ready Screen试剂盒和抗球蛋白卡;试剂盒与Capture-R Ready Screen对血样标本检测的阳性一致性百分率为98.0%,阴性一致性百分率为99.66%,总一致性百分率为99.43%。结论成功研发了基于固相凝集技术的用于红细胞IgG型同种免疫性不规则抗体检测的试剂盒,该试剂盒具有灵敏度好、保存期长、性能稳定等优势,与进口同类试剂盒等效。     

Antibodies to hydrocortisone in reagent red cells causing positive antibody screening tests

When a patient's serum contains a temperature-independent antibody reacting with all antibody screening and antibody identification panel cells but with few or no units of blood used for crossmatching, one should suspect an antibody against a constituent of the suspension medium of the reagent blood cells. This observation is confirmed by negative reactions with a) washed reagent cells or b) another manufacturer's cells that do not contain the same additives. Two patients are described with antibodies to hydrocortisone that are present in one manufacturer's antibody screening cells and identification panels. The hydrocortisone was added by the manufacturer to prevent hemolysis of the reagent red cells. The patient's antibodies were IgM, complement independent, and nonneutralizable by prior incubation with hydrocortisone. The addition of hydrocortisone to other manufacturers' reagents converted previously negative reactions to the same level of positivity as was seen with the reagent from the index manufacturer. Antibodies to reagent constituents can cause delays in finding compatible blood. It is suggested that manufacturers delete irrelevant additives or those of questionable necessity from their reagents.     

解离红细胞致敏抗体的3种方法比较

目的　寻找一种快速、简便、敏感的放散试验方法。方法　分别用氯仿和传统加热、乙醚法对 1 3例被IgG和IgM血型抗体同时致敏的红细胞进行放散试验 ,检测放散液中红细胞抗体效价。 结果　在 3种放散方法中 ,氯仿法不仅所获的放散液量多、颜色浅而透明 ,而且敏感性也不低。结论　氯仿法放散试验操作简便快速 ,安全 (试剂不易燃烧 ) ,且可同时放散出吸附在红细胞上的IgG和IgM抗体     

Evaluation of a solid phase red cell adherence technique for platelet antibody screening

Summary. Solid-phase red-cell adherence (SPRCA) techniques in platelet serology are used mainly for crossmatching. A SPRCA method for general diagnostic application was evaluated in parallel with the platelet suspension immunofluorescence test (PIFT). Of 149 patient sera sent for investigation of thrombo-cytopaenia, 76 were negative and 59 positive when studied by both methods, eight positive by PIFT only and six positive by SPRCA only. The reactivity observed for 24 sera containing HLA antibodies tested with chloroquine-treated and untreated platelets was similar for both methods. All of 14 sera containing quinine-associated antibodies reacted strongly to both techniques in the presence of added quinine. In comparison, however, whereas all sera were non-reactive to SPRCA in the absence of added quinine, and with PIFT, seven of the sera reacted weakly. Titration studies with three examples of anti-Pl^A1 and five sera containing HLA antibodies generally showed a one doubling dilution lower titre with the SPRCA procedure. End-point interpretation, however, was more readily achieved with the SPRCA method. The SPRCA technique displays similar sensitivity and specificity to the PIFT and is recommended for use by routine hospital laboratories to screen platelet antibodies.     

Efficient cutoff points for three screening tests for detecting undiagnosed diabetes and pre-diabetes: an economic analysis

OBJECTIVE: Opportunistic screening for undiagnosed type 2 diabetes and pre-diabetes (either impaired glucose tolerance or impaired fasting glucose) is recommended by the American Diabetes Association. The aim of this study was to determine efficient cutoff points for three screening tests for detecting undiagnosed diabetes alone or both undiagnosed diabetes and pre-diabetes. RESEARCH DESIGN AND METHODS: We estimated the number of individuals with undiagnosed diabetes alone or with both undiagnosed diabetes and pre-diabetes that could be detected by using different cutoff points for each screening test as the product of the prevalence of each condition, the sensitivity of the tests at each cutoff point for identifying each condition, and the number of individuals who would be eligible for screening in the U.S. We estimated the total cost of opportunistic screening by multiplying the cost for screening one person by the number of individuals screened. RESULTS: The most efficient cutoff points for both detecting pre-diabetes and undiagnosed diabetes (100 mg/dl for the fasting plasma glucose test, 5.0% for the HbA(1c) test, and 100 mg/dl for the random capillary blood glucose test) were less than those for detecting undiagnosed diabetes alone (110 mg/dl for the fasting plasma glucose test, 5.7% for the HbA(1c) test, and 120 mg/dl for the random capillary blood glucose test). CONCLUSIONS: A lower cutoff value should be used when screening for pre-diabetes and undiagnosed diabetes together than when screening for undiagnosed diabetes alone.     

Clinical evaluation of a solid-phase test for red cell antibody screening of pregnant women

BACKGROUND: The aims of this study were to evaluate the results of a new solid-phase screening test for detecting atypical red cell (RBC) antibodies in a large number of pregnant women and to compare these results to the clinical outcome of the newborn. STUDY DESIGN AND METHODS: A total of 38,700 infants born in Stockholm were studied retrospectively. Of these infants, 18,500 were born to pregnant women screened with the solid-phase test. Data were collected on all newborns with a positive direct antiglobulin test (DAT) and on infants requiring an exchange transfusion or a blood transfusion. These data were correlated to the screening results for the mothers. RESULTS: Of 409 DAT-positive newborns, a serologic explanation for the positive DAT was found in 349. Three hundred four cases were due to ABO incompatibility between mother and child; 19 of these infants needed an exchange transfusion. Forty-two cases were due to unexpected maternal RBC antibodies; 11 of these infants were given an exchange transfusion. All 11 were identified before birth. Three other infants had DAT-positive tests due to ABO incompatibility and to unexpected maternal RBC antibodies. CONCLUSION: ABO incompatibility is a major indication for exchange transfusion in DAT-positive newborns. There was no evidence that the solid-phase screening test had failed to detect any clinically significant RBC antibodies. Finally, the results of this study do not indicate a need for routine screening of D+ women more than once during each pregnancy.     

Sensitivity and specificity of different antibody tests for detecting varicella-zoster virus

IntroductionAntibody tests for detecting varicella-zoster virus include the fluorescent-antibody-to-membrane-antigen (FAMA) assay, immune adherence hemagglutination assay (IAHA), enzyme immunoassay (EIA), and the glycoprotein-based enzyme-linked immunosorbent assay (gpELISA). Although FAMA and gpELISA are highly sensitive, FAMA is not available commercially. Therefore, this study was performed to compare potential high-sensitivity tests with commercially available tests.MethodsFour antibody tests, FAMA, gpELISA, EIA, and IAHA, were performed using sera collected from 32 children aged 7 months–10 years. Using FAMA as a reference, the sensitivity and specificity of gpELISA, EIA, and IAHA were assessed. Subsequently, using gpELISA as a reference, the positive agreement rate of EIA and IAHA was assessed.ResultsOn a reference scale with FAMA set at 100%, the sensitivity and specificity of the antibody tests were as follows: gpELISA, 67% and 100%; EIA, 67% and 100%; and IAHA, 47% and 100%, respectively. The positive agreement rates of EIA and IAHA relative to gpELISA were 86% and 64%, respectively.Conclusions: gpELISA had a lower positive rate than did FAMA, and showed comparable sensitivity to that of EIA.