摘要
目的通过收集国内市场上常见的进口抗体筛查(抗筛)细胞和国产抗筛细胞,了解其抗原构成,比较检出不规则抗体的能力。方法选取临床抗筛阳性或可疑阳性标本111份,3个月前有过输血史的临床抗筛阴性标本204份,3种国产抗筛细胞(A、B、C)和进口D细胞同时采用微柱凝胶法做抗体筛查,阳性结果可疑阳性到4+凝集阳性划分为1到5个等级从。对抗筛阳性标本作抗体鉴定。结果 4种抗体筛查细胞抗原谱存在差异,A、B、C细胞同D细胞相比具有剂量效应的抗原(如C,c,E,e;M,N,S,s;Fya,Fyb;Jka和Jkb)不全为纯合子;A、C细胞未包含K抗原,A、D细胞未包含Dia抗原,4种细胞均未包被Mur抗原。4种抗体筛查细胞检测结果一致的标本有268份(201份均为阴性,67份均为阳性),不一致的有47份,4种抗体筛查细胞的检测结果差异存在统计学意义(χ2=105.10,P<0.0001)。对47份标本中的37份作抗体鉴定,以抗体鉴定结果为参照标准,A和D细胞表现最好,C细胞假阳性最多(29/37),B细胞假阴性最多(6/37)。4种抗体筛查细胞的阳性等级在67份阳性的标本中存在统计学差异,以A和D阳性等级较高(P<0.001,χ2=26.10)。结论不同厂家抗体筛查细胞质量存在差异。国产抗体筛查细胞的抗原有待进一步规范,一方面具有剂量效应的抗原(如C,c,E,e;M,N,S,s;Fya;Fyb;Jka和Jkb)应为纯合子,否则可能漏检一些低效价抗体;另一方面一些在中国人群中分布频率较高的抗原,如Diego血型系统中的Dia抗原和MNS系统中的Mur抗原,及一些在中国人群中分布频率较低的抗原,如Kell血型系统中的K抗原,应有明确规范包含在抗体筛查细胞中。
Object This study compared the ability of several market-available red blood cell reagents in China to screen unexpected antibodies and investigated their antigen sources. Methods 204 antibody-negative serums from patients with transfusion history in the last three months and 111 antibody-positive serums were collected.Results The four cell kits presented different antigen range. These antigens showed dose effect,such as C,c,E,e; M,N,S,s; Fy^a; Fy^b; Jk^a 和 Jk^b,which were not all double-dose expression on A,B and C. There is no K antigen of Kell blood group system in A and C,and no Dia antigen of Diego blood group system in A and D. None of these four reagent cells include Mur antigen of MNS blood sub-group system. Significant difference can be found among these four cell regents（ χ^2= 105. 10,P〈0. 000 1）,where A and D showed the best performance; C had the worst sensitivity; and B had the worst specificity. A distinguish difference was seen among these four cell reagents when all of them were applied to 67 positive serum samples（ P〈0. 001,χ^2= 26. 10）. The positive classification of A and D were more refined than the others. Conclusion The ability of screening unexpected antibodies was significantly different among the four cell reagents. Regulations are needed in two aspects to improve cell reagent performance. To start with,dose-effect antigens should be double-dose expression. Then,a guideline is needed to clarify whether Dia,Mur and K antigen should be included in the cell reagent kits.
出处
《中国输血杂志》
北大核心
2017年第11期1243-1245,共3页
Chinese Journal of Blood Transfusion
基金
卫生部政策法规司<不规则抗体筛查试剂红细胞质量要求>资金资助(20131001)
关键词
输血
不规则抗体
抗筛细胞
比对
unexpected antibody
transfusion
compare tests
