摘要
目的探讨酶-IAT技术在红细胞抗体鉴定中的应用意义。方法对2018年1—9月本院检验科输血前红细胞血型抗体筛选、抗体鉴定中出现的弱阳性,无法确定抗体特异性的标本28例,使用二步酶处理谱细胞方法分别再做抗体鉴定,通过分析酶处理谱细胞前后的抗体鉴定结果,确定抗体特异性;从中选取有代表性6例,结合血型结果,探讨酶处理技术对于不同血型系统的作用,并分析酶处理技术的应用范围。结果红细胞血型抗体筛选、鉴定为弱阳性的28例标本中,经酶处理谱细胞后71.43%(20/28)标本确定了抗体特异性20例,其中Rh血型系统抗体占60%(12/28),Kidd抗体占15%(3/20),Lewis抗体占10%(2/20),自身抗体15%(3/20);28.57%(8/28)标本仍未检出抗体特异性。结论酶-IAT法可以增强抗体鉴定弱阳性标本的检出能力,明确抗体特异性,有益于保障临床输血安全;但若存在自身抗体,酶处理技术的应用会受到限制,还需考虑结合其他试验解决问题。
Objective To study the application of two-stage enzyme test in the identification of irregular antibody. Methods From January to September 2018, 28 samples screened to have very weak antibodies with uncertian serologic specificity during routine pre-transfusion test were further identified by two-stage enzyme test. The specificity of antibodies was determined by analyzing the the results of antibody identification before and after two-stage enzyme test. Six representative cases were selected. Combined with the results of blood group typing, the adoption of enzyme test on different blood group systems was discussed, along with the application extent of enzyme test.Results Among the 28 samples screened and identified as weakly positive, specificity were identified in 71.43%(20/28) after using enzyme test, among which Rh blood group system antibodies accounted for 60%(12/28), Kidd antibodies for 15%(3/20), Lewis antibodies for 10%(2/20), autoantibodies for 15%(3/20), and antibodies whose specificity remained unknown for 28.57%(8/28). Conclusion Enzyme-IAT test can enhance the ability to detect weak antibodies and clarify the specificity, which helps to ensure the safety of clinical blood transfusion. Autoantibodies, however, precluded the application of enzyme test to some extent, and other methods should be combined for a better diagnosis.
引文
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