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.

Clinical application of microcolumn gel immunoassay in transfusion-related experiments

Objective To explore the applicable value of microcolumn gel immunoassay(MGIA) in transfusion-related experiments(blood typing, cross matching, antibody titration), and carry out its methodical evaluation. Methods Fifteen anti-Rh D positive samples from 55 Rh D negative patients, twenty-one cases of discrepant blood typing and twenty-nine cross matching positive samples were studied by applying MGIA and routine tube test simultaneously. Antibody titer data from 853 pregnant women with type O were brought into statistics. Results In 55 Rh D negative samples, the positive rate of Rh D antibody tested by MGIA and tube test was 27.27%(15/55) and 21.82 % (12/55) respec-tively,and the samples with titer 1:4 above got the coincident results by the two methods. For twen-ty-one discrepant blood typing samples, 11 cases with weak reaction showed discrepant results by MGIA;however, all samples showed weak reaction by tube test. In 29 samples with cross matching positive by MGIA,2 cases were confirmed to be negative by tube test. For the pregnant women with type O,IgG antibody titer abnormal ratio was 33.18%(144/434) if their respective husbands was with type A,33.17%(139/419) if their respective husbands was with type B.Conclusion MGIA is charac-teristic of convenience, fastness and reliability of test results, but its false-positive or false-negative should be paid attention to. When abnormal results occur, traditional tube test as well asmicroscopic examination should be performed in parallel.