贫血患者的免疫血液学检查结果分析

目的研究自身免疫性溶血性贫血（AIHA）的诊断方法。方法采用直接抗IgG试验及热放散试验,以检查贫血患者红细胞上结合的自身抗体;采用抗体筛选试验及DL试验,以检查贫血患者血液中游离的自身抗体;采用直接抗C3d试验,以检查贫血患者红细胞上结合的补体C3d片段。将上述试验结果联合运用,以诊断贫血患者中的各类AIHA患者。结果在239例贫血患者中,共诊断出46例贫血患者为AIHA患者,诊断率为19.25%;在诊断出的AIHA患者中,温型AIHA患者占27例（15男12女）、混合型AIHA患者占8例（5男3女）及冷凝素综合症（CAS）患者占11例（6男5女）;239例贫血患者按性别分类,在102例男性及137例女性贫血患者中,分别诊断出26例男性及20例女性贫血患者为AIHA患者,诊断率分别为25.49%及14.60%,两者比较有显著性差异（χ~2=4.463,P〈0.05）。结论采用若干免疫血液学试验联合运用,可正确诊断贫血患者中的各类AIHA患者。

Results of immune hemotological test of anemic patients

Aim To investigate the diagnosis of various kinds of autoimmune hemolytic anemia（AIHA）.Methods Direct anti IgG test and thermal elution test was used to detect the autoimmune antibodies combined in red blood cells of anemic patients and antibody selection test and DL test were used to determine the free autoimmune antibodies in blood of anemic patients.Direct anti C3d test was also used to determine complement C3d fragments combined with red blood cells of anemic patients.Results There 46 anemic patients were diagnosed as AIHA patients（19.25%）and 27 of them were warm-type AIHA patients（15 males and 12 females）,8 of them were mixed-type AIHA patients（5 male and 3 female）,and 11 of them were cold agglutinin syndrome（CAS）patients（6 male and 5 female）.There 26 males and 20 females anemic patients were separately diagnosed as AIHA patient.Among 102 male and 137 female anemic patients,26 males and 20 females were diagnosed as having AIHA,accounted for 25.49% and 14.60%,showig significant difference（χ~2=4.463,P 0.05） Conclusion Joint detection with several immune hematological tests can accurately diagnose various kinds of AIHA patients among anemic patients for the purpose of clinical treatment.