不同标本及处理方式对微柱凝胶卡式法交叉配血试验结果的影响
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摘要
目的探讨不同标本(抗凝血、促凝血)和处理方式(离心方式、红细胞悬液浓度)对微柱凝胶卡式法交叉配血试验结果的影响。方法选择60份待输血患者抗凝血和促凝血标本,比较孵育温度和时间(Ⅰ组~Ⅳ组)、离心转速(Ⅴ组和Ⅵ组)、红细胞悬液浓度(Ⅶ组和Ⅷ组)对微柱凝胶卡式法交叉配血试验结果的影响。结果Ⅰ、Ⅲ和Ⅳ组标本中分别有34、14和26份为阳性,能够从微柱凝胶上层挑出纤维蛋白凝块;Ⅱ组标本均为阴性。四组促凝血血清样本交叉配血试验阴性率比较,差异具有统计学意义(P<0.05);Ⅰ组和Ⅳ组促凝血血清样本交叉配血试验阴性率比较,差异不显著(P>0.05)。Ⅴ组和Ⅵ组经不同离心速度处理后以血浆标本进行交叉配血试验,结果显示,Ⅴ组和Ⅵ组交叉配血试验阴性率均为100.00%;两组交叉配血试验阴性率比较,差异无统计学意义(P>0.05)。Ⅶ组中,0.5%和0.8%浓度的红细胞悬液的交叉配血试验均为阴性,所有红细胞均完全沉积于凝胶底部,随着红细胞浓度≥1.0%时,沉积于凝胶底部的红细胞高度逐渐增加。Ⅷ组中,0.5%、0.8%和1.0%浓度的红细胞悬液的交叉配血试验中所有红细胞均位于凝胶上,2.0%、3.0%和5.0%浓度的红细胞悬液的交叉配血试验中发现有红细胞沉积于凝胶底部,随红细胞浓度增加,红细胞逐渐充斥在整个微柱凝胶中。结论不同的标本和处理方式对微柱凝胶卡式法交叉配血试验结果的影响较大,不当的处理方式会造成假阳性结果;未抗凝血液标本中纤维蛋白短时间内无法析出,不应用于急诊快速配血;红细胞悬液浓度不宜过大,保持在0.5%~0.8%效果较好。
Objective To investigate the effects of different specimens(anticoagulant and procoagulant) and processing methods(centrifugal method and concentration of erythrocyte suspension) on the results of cross matching test by microcolumn gel card method. Methods A total of 60 anticoagulant and procoagulant specimens were selected to compare the effects of incubation temperature and time(group Ⅰ-Ⅳ), centrifugal speed(group Ⅴ-Ⅵ), and concentration of erythrocyte suspension(group Ⅶ-Ⅷ) on the results of cross matching test by microcolumn gel card method. Results In the group Ⅰ, Ⅲ and Ⅳ, 34,14 and 26 specimens were positive, respectively, and fibrin clot could be extracted from the upper layer of microcolumn gel.All the specimens in the group Ⅱ were negative. There was significant difference in the negative rate of cross matching test of procoagulant specimens among the four groups(P <0.05); there was no significant difference in the negative rate of cross matching test of procoagulant specimens between the group Ⅰ and group Ⅳ(P>0.05). The cross matching test of plasma specimens in the group Ⅴ and Ⅵ after different centrifugal speed showed that the negative rates of cross matching in the group Ⅴ and Ⅵ were 100.00%; there was no significant difference in the negative rate of cross matching test between the two groups(P>0.05). In the group Ⅶ, cross matching test of erythrocyte suspension at concentrations of 0.5% and 0.8% were negative, and all erythrocytes were completely deposited on the bottom of gel; when the erythrocytes concentration was more than 1.0%, the erythrocyte height at the bottom of gel was gradually increased. In the group Ⅷ, all the erythrocytes were located in gel on the cross matching test of erythrocyte suspension concentration at 0.5%, 0.8% and 1.0%; the cross matching test of erythrocytes suspension at concentrations of 2.0%, 3.0% and 5.0% showed that erythrocytes were deposited on the bottom of gel, and with the increase of erythrocyte concentrations, erythrocytes gradually filled the whole microcolumn gel.Conclusion The effect of different specimens and processing methods on the results of the cross matching test by microcolumn gel card method is relatively large, and the improper handling can result in false positive results. Fibrin in non-anticoagulant blood samples can not be precipitated in a short time and should not be used in emergency rapid blood matching. The concentration of erythrocyte suspension should not be too large, and when the erythrocyte suspension concentrations is kept between 0.5% and 0.8%, the accuracy of the result is better.
Objective To investigate the effects of different specimens(anticoagulant and procoagulant) and processing methods(centrifugal method and concentration of erythrocyte suspension) on the results of cross matching test by microcolumn gel card method. Methods A total of 60 anticoagulant and procoagulant specimens were selected to compare the effects of incubation temperature and time(group Ⅰ-Ⅳ), centrifugal speed(group Ⅴ-Ⅵ), and concentration of erythrocyte suspension(group Ⅶ-Ⅷ) on the results of cross matching test by microcolumn gel card method. Results In the group Ⅰ, Ⅲ and Ⅳ, 34,14 and 26 specimens were positive, respectively, and fibrin clot could be extracted from the upper layer of microcolumn gel.All the specimens in the group Ⅱ were negative. There was significant difference in the negative rate of cross matching test of procoagulant specimens among the four groups(P <0.05); there was no significant difference in the negative rate of cross matching test of procoagulant specimens between the group Ⅰ and group Ⅳ(P>0.05). The cross matching test of plasma specimens in the group Ⅴ and Ⅵ after different centrifugal speed showed that the negative rates of cross matching in the group Ⅴ and Ⅵ were 100.00%; there was no significant difference in the negative rate of cross matching test between the two groups(P>0.05). In the group Ⅶ, cross matching test of erythrocyte suspension at concentrations of 0.5% and 0.8% were negative, and all erythrocytes were completely deposited on the bottom of gel; when the erythrocytes concentration was more than 1.0%, the erythrocyte height at the bottom of gel was gradually increased. In the group Ⅷ, all the erythrocytes were located in gel on the cross matching test of erythrocyte suspension concentration at 0.5%, 0.8% and 1.0%; the cross matching test of erythrocytes suspension at concentrations of 2.0%, 3.0% and 5.0% showed that erythrocytes were deposited on the bottom of gel, and with the increase of erythrocyte concentrations, erythrocytes gradually filled the whole microcolumn gel.Conclusion The effect of different specimens and processing methods on the results of the cross matching test by microcolumn gel card method is relatively large, and the improper handling can result in false positive results. Fibrin in non-anticoagulant blood samples can not be precipitated in a short time and should not be used in emergency rapid blood matching. The concentration of erythrocyte suspension should not be too large, and when the erythrocyte suspension concentrations is kept between 0.5% and 0.8%, the accuracy of the result is better.
引文
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[12]林燕,黄开荣,张春燕,等.微柱凝胶卡氏配血法的临床应用[J].实验与检验医学,2011,29(4):381-382.
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[14]田静辉.研究不同标本对卡式法交叉配血试验结果的影响[J].智慧健康,2017,3(19):16-17.
[15]谢霞,崔效玮,杨世明,等.微柱凝胶法输血相容性检测弱凝集现象的影响因素分析[J].细胞与分子免疫学杂志,2018,34(8):68-71.
[16]叶巧国,杨毓,何静,等.微柱凝胶卡式法在交叉配血及不规则抗体检测中的应用[J].现代医院,2011,11(12):59-61.
[17]江涛,张勇萍,杨世明,等.血标本纤维蛋白析出对血型鉴定和交叉配血及抗体筛查的影响[J].国际检验医学杂志,2017,38(20):2885-2887.
[18]闫朝春,蒋玲,陈丽梅,等.导致微柱凝胶卡式交叉配血试验假阳性结果的原因分析[J].国际检验医学杂志,2011,32(15):1737-1738.
[19]余占明,马国丽,李丽.微柱凝胶法与凝聚胺法交叉配血不合原因分析[J].中国实用医药,2009,4(20):72-73.
[20]陈丽娟,高华英.微柱凝胶卡式法交叉配血次侧不合原因分析[J].北京医学,2010,32(8):686-687.
[2] CHANG C,BROWN M,DAVIES L,et al.Evaluation of Erytra誖fully automated analyser for routine use in transfusion laboratory[J].Transfus Med,2013,24(1):33-38.
[3]唐玉杰,唐生明,施丽.输血患者临床交叉配血方法及输血后溶血状况分析[J].海南医学,2017,28(6):985-987.
[4] LIU R,LIANG P.Determination of gold by nanometer titanium dioxide immobilized on silica gel packed microcolumn and flame atomic absorption spectrometry in geological and water samples[J].Anal Chim Acta,2007,604(2):114-118.
[5]何子毅,刘仁强,刘景春,等.纤维蛋白析出对微柱凝胶试验结果影响的解决方法研究[J].中山大学学报:医学科学版,2009,30(2):242-245.
[6] FINCK R,LUIDEGUZMAN C,TENG SM,et al.Comparison of a gel microcolumn assay with the conventional tube test for red blood cell alloantibody titration[J].Transfusion,2013,53(4):811-815.
[7]余海燕.不同标本对卡式法交叉配血试验结果的影响分析[J].检验医学与临床,2017,14(3):386-388.
[8]周安祥,王思丽,张默吟.微柱凝胶卡式血型鉴定的干扰因素分析及处理[J].吉林医学,2012,33(23):5044-5045.
[9] SHIREY RS,CAI W,MONTGOMERY RA,et al.Streamlining ABO antibody titrations for monitoring ABO-incompatible kidney transplants[J].Transfusion,2010,50(3):631-634.
[10] DITTMAR K,PROCTER JL,CIPOLONE K,et al.Comparison of DATs using traditional tube agglutination to gel column and affinity column procedures[J].Transfusion,2010,50(10):1258-1262.
[11]贲燕华,金勇,纪桂香.探讨标本因素对微柱凝胶卡配血法的影响[J].临床输血与检验,2014,16(2):192-194.
[12]林燕,黄开荣,张春燕,等.微柱凝胶卡氏配血法的临床应用[J].实验与检验医学,2011,29(4):381-382.
[13] ZOUGAGH M,RUDNER PC,DE AT,et al.On-line preconcentration and determination of cobalt by DPTH-gel chelating microcolumn and flow injection inductively coupled plasma atomic emission spectrometry[J].Anal Bioanal Chem,2004,378(2):423-428.
[14]田静辉.研究不同标本对卡式法交叉配血试验结果的影响[J].智慧健康,2017,3(19):16-17.
[15]谢霞,崔效玮,杨世明,等.微柱凝胶法输血相容性检测弱凝集现象的影响因素分析[J].细胞与分子免疫学杂志,2018,34(8):68-71.
[16]叶巧国,杨毓,何静,等.微柱凝胶卡式法在交叉配血及不规则抗体检测中的应用[J].现代医院,2011,11(12):59-61.
[17]江涛,张勇萍,杨世明,等.血标本纤维蛋白析出对血型鉴定和交叉配血及抗体筛查的影响[J].国际检验医学杂志,2017,38(20):2885-2887.
[18]闫朝春,蒋玲,陈丽梅,等.导致微柱凝胶卡式交叉配血试验假阳性结果的原因分析[J].国际检验医学杂志,2011,32(15):1737-1738.
[19]余占明,马国丽,李丽.微柱凝胶法与凝聚胺法交叉配血不合原因分析[J].中国实用医药,2009,4(20):72-73.
[20]陈丽娟,高华英.微柱凝胶卡式法交叉配血次侧不合原因分析[J].北京医学,2010,32(8):686-687.