中山地区万例患者不规则抗体微柱凝胶筛查的研究

目的研究微柱凝胶试验（MGT）技术要领，了解中山地区患者大样本中的不规则抗体（IAb）发生频率及其特异性。方法比较进口戴安娜MGT和其他经典常规方法检测红细胞（RBC）IAb的敏感性（效价）；分析试验中的可能干扰因素，如抗凝刺、溶血、脂血等；找出MGT的不足，并研究解决方法；以MGT完成40485例受血者和孕妇IAb的筛查。结果在平行试验中，MGT检出了所有IgG和IgM性质IAb，其测定IgG抗体的效价均较传统抗人球蛋白试验高1～2个滴度，但MGT标准（常规）法测IgM的IAb效价较盐水法低1～2个滴度，若采用MGT改良法，即增加室温孵育时间，则结果同盐水法一致；以MGT对40486例受检者进行了RBC-IAb常规筛查，结果61例阳性，占0．15％（61／40485）。结论MGT对大多数有重要临床意义的RBC-IAb敏感性高、特异性强，受抗凝剂和溶血、脂血的影响小，结果准确，简便快捷，标本用量少，易于自动化和大批量检测。

Study on 40 485 cases of irregular antibodies in patients with micro column gel screening in Zhongshan area

Objective Study on micro-column gel test （MGT） technology in order to understand the large sample of patients with irregular antibodies （IAb） and its specific frequency in Zhongshan rejion. Methods To examine the sensitivity of red blood cells IAb （titer） with MGT by DianaGel Coombs and other conventional methods of classical analysis of trials that may interfere with factors such as anticoagulant,hemolysis, blood lipid; to find out the inadequacies of the results by MGT ,and to obtain the ways of solving the problems ; and to complete the selection of the 40 485 cases of MGT recipients IAb screening and pregnant women. Results In parallel experiments,all of the IgG and IgM of IAb was defected out by MGT,when in the detection of IgG antibodies,MGT is higher than that of the traditional mehod by titer 1-2 months. However,by the MGT standard method,Iab titers in IgM is lower than that of the saline by titer 1-2 months,and if by the modified method of MGT,i. e,an increase of incubation time at room temperature,then the result is in line with the one by the saline method;40,485 subjects had reeieived RBC-IAb conventional screening by MGT,among whom there were 61 cases of positive, accounting for 0. 15 % （61/40 485）. Conclusion When to detect most clinical significance of red blood cells IAb ,MGT has high sensitivity and specificity, and it is subject to anticoagulants and hemolysis, blood lipid effects of small, accurate, simple, fast, specimens with small,easy automation and can be detected in large quantities.