直接抗人球蛋白试验在患者输血疗效中的临床意义分析

目的研究直接抗人球蛋白试验(DAT)对输血患者临床疗效的影响。方法收集60例临床上DAT阳性需输血患者为研究组,选择同期60例DAT阴性需输血患者为对照组,同时对60例DAT阳性标本作抗体及补体分型试验和抗体强度测定,并对两组患者以及DAT阳性抗体不同类型与强度的患者进行输血后显效率对比分析。结果DAT阴性患者输血后有效率为88.33%、其中显效率为63.34%;DAT阳性患者输血后有效率为75.00%、其中显效率为26.67%,有统计学意义(P<0.01);60例DAT阳性患者抗体类型以多种抗体组(含IgG+C3d及在IgG+C3d抗体基础上含有IgM、IgA型抗体和/或C3c补体)为主占61.67%、单纯IgG占20.00%、单纯C3d占18.33%;单纯C3d组输血后有效率高于单纯IgG组(P<0.05)、单纯IgG组输血后有效率高于多种抗体组(P<0.05);不同抗体强度之间比较发现,3+~4+组输血后显效率明显低于1+组,有统计学意义(P<0.01)。结论DAT阳性是影响患者输血治疗效果的重要因素之一,且治疗效果与抗体类型及抗体强度具有一定的关系。因此DAT检测、抗体类型及抗体强度对贫血患者的输血治疗效果和判断预后具有重要的参考意义。

Clinical Significance of Direct Anti-human Globulin Test in Patients'Blood Transfusion Effect

Objective To study the effect of direct anti-human globulin test(DAT)on the clinical efficacy of transfusion patients.Methods Collect 60 clinically DAT-positive patients to be transfused as the study group,and select 60 DAT-negative patients to be transfused during the same period as the control group.At the same time,60 DAT-positive specimens were tested for antibody typing and complement typing,antibody strength determination,Comparative analysis of the marked efficiency after blood transfusion was performed in two groups of patients and patients with different types and antibody intensities of DAT-positive antibodies.Results After transfusion,the effective rate of DAT-negative patients was 88.33%,and the effective rate was 63.34%,the effective rate of DAT-positive patients was 75.00%,and the effective rate was 26.67%,which was statistically significant(P<0.01).The antibody types of 60 DAT-positive patients were mainly composed of multiple antibody groups(including IgG+C3d and IgG+C3d antibodies containing IgM,IgA antibodies and/or C3c complement),accounts for 61.67%,IgG alone accounts for 20.00%,C3d accounts for 18.33%.The efficiency of C3d group after transfusion was higher than that of IgG group(P<0.05),and the efficiency of IgG group was higher than that of multiple antibody group(P<0.05).The comparison of different antibody strengths found that the significant efficiency after transfusion in the 3+~4+group was significantly lower than that in the 1+group,which was statistically significant(P<0.01).Conclusion Positive anti-human globulin test is one of the important factors affecting the effect of blood transfusion treatment,and the treatment effect has a certain relationship with antibody type and antibody intensity.Therefore,DAT detection,antibody type and antibody intensity have important reference significance for the effect of transfusion treatment and prognosis of anemia patients.