自制Coombs微柱凝胶卡的临床应用研究

目的探讨自制Sephadex-G50Coombs微柱凝胶卡应用于稀有血型抗体筛选和新生儿溶血病检测的可行性。方法以Sephadex-G50凝胶为载体,制备Sephadex-G50Coombs微柱凝胶卡。取无偿献血者血清与稀有血型(Mur)抗原阳性红细胞加入凝胶卡反应腔,37℃孵育后15min离心,观察结果。再取阳性反应者血清,用2-Me灭活IgM型抗体后,重复前述步骤,以确定是否含IgG型抗-Mur。取新生儿血液标本,进行直抗实验、游离抗体实验和放散液抗体检测实验。结果 2 600名无偿献血者中,检出1例IgM型抗-Mur。246例新生儿溶血病标本中,检出ABO溶血病210例,RhD溶血病5例,RhE溶血病2例,抗-M和抗-Jka引发的溶血病各1例。自制凝胶卡与进口凝胶卡检测结果一致。结论自制Sephadex-G50Coombs微柱凝胶卡与进口凝胶卡检测结果差异无统计学意义,且具有成本低、工艺简单的特点,可用于血型血清学临床实验。

The clinical application study of homemade coombs gel card

Objective To study the clinical application of homemade gel coombs card in screening rare antibody and determining hemolytic disease of the newborn. Methods Sephadex-G50 gel particle was used as carrier in home- made gel card. Donor＇s serum and red blood cell suspension with Mur antigen positive were added to the reaction chamber of the card,then it was centrifuged after it had been incubated at 37 ℃ for 15 minutes. The positive reaction serum was used to repeat the same test with the gel card after it had been dealt with 2-Me to inactive the IgM anti- bodies so as to ascertain whether it had IgG anti-Mur. The newborn＇s blood specimens were used to do direct anti- globulin test, free antibody determination and eluate test. All the tests were done with both homemade coombs card and DG GEL Coombs card. Results IgM anti-Mur antibody was found in one of 2 600 donors. 246 cases were diag- nosed HDN,including 210 ABO-HDN cases,5 RhD-HDN cases,2 RhE-HDN cases and 2 cases caused by anti-M and anti-JK. Conclusion There is no difference between the homemade card and DG GEL card in this study. Lower cost and simple process will give the homemade card more application in routine work.