低温孵育微柱凝集法提高血清低效价不规则抗体检出率的应用分析OA
Analysis of the Application of the Low-Temperature Incubation Microcolumn Agglutination Method to Improve the Detection Rate of Serum Low-Titer Irregular Antibodies
目的 探讨低温孵育微柱凝集法在提高低效价不规则抗体检出率中的应用与临床意义,避免不规则抗体漏检导致溶血性输血反应,准确鉴定抗体特异性,进一步保障临床用血安全有效.方法 在空军军医大学西京医院2024年1月～5月231例因抗筛阳性或交叉配血不合送检参比实验室的标本中筛选出7例怀疑有盐水抗体的标本作为研究对象,采用室温下盐水介质法复核待检标本抗体筛查,并与全自动血型仪结果进行比对;抗体鉴定试验同时采用37℃孵育30min和4℃孵育10min两种方案进行检测,分析不同温度下谱细胞凝集格局和凝集强度的差异.结果 7例标本中6例全自动血型仪抗体筛查结果表现为弱阳性,1例为阴性;在盐水介质中复核抗体筛查,复核结果均为阳性,1例标本反应格局与全自动血型仪结果存在差异.受检标本在37℃孵育下凝集强度较弱或反应格局不明确,4℃孵育后反应均增强.5例检出抗-M抗体,红细胞表型均为NN;1例检出抗-Lea抗体,1例为抗-Lea联合抗-Leb抗体,表型均为Le(a-b-).结论 低温孵育微柱凝集法可明显提高MNS和Lewis血型系统抗体检出率和抗体特异性鉴定准确率,避免低效价抗体漏检.
Objective To investigate the application and clinical significance of low-temperature incubation microcolumn ag-glutination method in improving the detection rate of low-titer irregular antibodies,thereby preventing hemolytic transfusion reactions caused by missed detection of irregular antibodies,accurately identifying antibody specificity,and further ensuring the safety and efficacy of clinical blood use.Methods From January to May 2024,seven specimens suspected of having saline anti-bodies were selected from 231 specimens sent to the reference laboratory at Xijing Hospital of Air Force Medical University due to positive antibody screening or cross-matching incompatibility.The antibody screening of the specimens was verified using the saline medium method at room temperature,and the results were compared with those from a fully automatic blood type analyz-er.For antibody identification tests,two protocols were employed:incubation at 37℃for 30 minutes and incubation at 4℃for 10 minutes,to analyze differences in agglutination patterns and agglutination intensity of spectral cells at different temperatures.Results Among the 7 specimens,6 showed weakly positive results in the fully automated blood typing instrument's antibody screening,another one was negative.Upon rechecking the antibody screening using the saline medium method,all specimens tested positive,with 1 specimen exhibiting a reaction pattern that differed from the fully automated blood typing instrument's results.The tested specimens displayed weak agglutination or unclear reaction patterns when incubated at 37℃,but the reactions were enhanced after incubation at 4℃.Anti-M antibodies were detected in 5 cases,all with an erythrocyte phenotype of NN.An-ti-Lea antibodies were detected in 1 case,and anti-Lea combined with anti-Leb antibodies in another case,both with a phenotype of Le(a-b-).Conclusions The microcolumn agglutination method with low-temperature incubation can significantly improve the detection rate of antibodies and the accuracy of antibody specificity identification in MNS and Lewis blood group systems,there-by preventing the missed detection of low-titer antibodies.
张嵘;刘丽娜;廖红;李青;刘娅;侯雪佳;顾顺利;尹文;王文婷
中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032中国人民解放军空军军医大学西京医院输血科,西安 710032
医药卫生
低温孵育法微柱凝集法不规则抗体输血反应
low-temperature incubation methodmicrocolumn agglutination methodirregular antibodiestransfu-sion reaction
《现代检验医学杂志》 2026 (3)
38-45,8
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