微柱凝胶法检测ABO疑难血型的临床应用及方法学探讨

目的探讨微柱凝胶法（MGT）检测ABO疑难血型的敏感性及影响因素。方法应用（MGT）法检测38600例患者的ABO血型，同时用试管法进行复查对照，对正反定结果不一致的血标本，增加离心或37~C孵育时间去除血清中的纤维蛋白和冷凝集素，对血型抗原明显减弱或抗体效价降低者，采用增加定型血清或被检血清的剂量，预先将抗原抗体混合置37℃反应15—30min，然后采用（MGT）法检测。结果MGT法检测ABO血型抗原明显减弱或抗体效价降低者的敏感性高于试管法。MGT法检测ABO血型，对正反定结果不一致者35例，其中患者血浆含纤维蛋白9例、血清蛋白异常增高4例、高效价冷凝集素5例、血型抗原明显减弱8例、抗体效价降低9例。结论纤维蛋白、高效价冷凝集素、血型抗原减弱或抗体效价降低均可干扰ABO血型鉴定结果。增加离心或37℃孵育时间去除定型血清或患者血浆剂量血清中的纤维蛋白和冷凝集素，增加定型血清或患者血浆的剂量，预先将抗原抗体混合置37℃反应15—30分钟，然后采用MGT法检测，可提高ABO血型鉴定的准确性和输血安全。

Clinical Application and Methodology Study on Micro-cohmm Gel Technique in Detecting Suspicious ABO Blood Group

Objective To discuss the sensitivity and influencing factors of micro-column gel technique （MGT） in detecting suspicious ABO blood group. Methods A method of MGT was applied to detecting suspicious ABO blood group of 38600 patients, simultaneously, a test tube rethod was used to reexamine and contrast, centrifugation or 37 DEG C incubation time was increased to remove fibrin and cold agglutinin in serum as for blood samples whose positive and negative definite results were not consistent, a method for increasing doses of typing serum or detected serum was adopted as for the patients whose blood group antigen was prominently weakened or antibody titer was decreased, antigen- antibody was mixed in 37 DEG C and reacted for 15 to 30 minutes in advance, and then the method of MGT was adopted to detect. Results The sensitivity of using the method of MGT to detect the patients whose ABO blood group antigen was prominently weakened or antibody titer was decreased was higher than that of the test tube method. When the method of MGT was used to detect the ABO blood group, 35 patients had inconsistent positive and negative definite results, wherein patients whose blood plasma contained fibrin were nine, patients whose sennn protein was increased abnormally were four, patients who had high titer cold agglutinin were five, the patients whose blood group antigen was prominently weakened were eight, and patients whose antibody titer was decreased were nine. Conclusion Either the reduction of the fibrin, high titer cold agglutinin and blood group antigen or the decrease of antibody titer can interfere the identification results of ABO blood group. The centrifugation or 37 DEG C incubation time was increased to remove fibrin and cold agglutinin in typing serum or serum of plasma doses of patients, the doses of typing serum or patients＇ serum were increased, the antigen- antibody was mixed in 37 DEG C and reacted for 15 to 30 minutes in advance, and then the method of MGT was adopted to detect, which can increase the accurac