改良微柱凝胶法检测ABO变异型血型
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摘要
目的:建立用于检测ABO变异型血型的改良微柱凝胶法。方法:选取2016年11月至2018年5月温州医科大学附属第二医院育英儿童医院、温州市人民医院和瑞安市人民医院ABO血型凝集强度改变或正反定型不一致的患者12例。采用血型血清学检查和血型基因检测结合临床表现确认标本ABO血型;对已知血型标本用微柱凝胶法复核;用1% O型、A3亚型和A抗原减弱红细胞调整微柱凝胶法离心方式建立改良微柱凝胶法,并对全部标本进行检测。结果:12例标本中A3亚型1例,B(A)型3例,类孟买型3例,ABO抗原减弱5例;微柱凝胶法和盐水试管法检测敏感度相似,12例标本中只检出2例,检出比例为2/12;选定改良微柱凝胶法的离心方式为900 r/min离心2 min、4 ℃孵育30 min、1 800 r/min离心3 min;用改良微柱凝胶法检测12例标本,1例不能检出,检出比例为11/12。结论:本研究建立的改良微柱凝胶法通过改变微柱凝胶血型卡的离心方式、增加孵育时间和孵育温度,提高了检测敏感度,适合ABO变异型血型的筛检。
Objective: To establish a modified microcolumn gel method for the detection of ABO variant blood type. Methods: From November 2016 to May 2018, 12 patients with ABO blood group agglutination intensity change or inconsistent positive and negative stereotypes were selected from the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou People's Hospital and Rui'an People's Hospital. The ABO blood type of the specimens was confirmed by blood type serogy test and blood type gene test combined with clinical manifestations. The known blood group specimens were detected by microcolumn gel method. A modified microcolumn gel method was established by using 1% O, A3 subtype and A antigen weakened erythrocytes to adjust the way of centrifugation of microcolumn gel method, which was used to detect all the samples. Results: Of the 12 cases, there was 1 case of A3 subtype, 3 cases of B(A) type, 3 cases of Mumbai type and 5 cases of ABO blood group antigen with weak expression. The sensitivity of microcolumn gel method was similar to that of saline tube test. Only 2 of 12 specimens were detected, with the detection rate being 2/12. The centrifugation method of the modified microcolumn gel method was 900 r/min centrifugation 2 min, 30 min incubated at 4 °C and 1 800 r/min centrifugation 3 min. Only 1 case of the 12 specimens could not be detected by the modified microcolumn gel method, the detection rate being 11/12. Conclusion: The modified microcolumn gel method established in this study improves the detection sensitivity by changing the centrifuge mode and increased incubation time and incubation temperature of the microcolumn gel blood type card. It is suitable for screening ABO variant blood groups.
Objective: To establish a modified microcolumn gel method for the detection of ABO variant blood type. Methods: From November 2016 to May 2018, 12 patients with ABO blood group agglutination intensity change or inconsistent positive and negative stereotypes were selected from the Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou People's Hospital and Rui'an People's Hospital. The ABO blood type of the specimens was confirmed by blood type serogy test and blood type gene test combined with clinical manifestations. The known blood group specimens were detected by microcolumn gel method. A modified microcolumn gel method was established by using 1% O, A3 subtype and A antigen weakened erythrocytes to adjust the way of centrifugation of microcolumn gel method, which was used to detect all the samples. Results: Of the 12 cases, there was 1 case of A3 subtype, 3 cases of B(A) type, 3 cases of Mumbai type and 5 cases of ABO blood group antigen with weak expression. The sensitivity of microcolumn gel method was similar to that of saline tube test. Only 2 of 12 specimens were detected, with the detection rate being 2/12. The centrifugation method of the modified microcolumn gel method was 900 r/min centrifugation 2 min, 30 min incubated at 4 °C and 1 800 r/min centrifugation 3 min. Only 1 case of the 12 specimens could not be detected by the modified microcolumn gel method, the detection rate being 11/12. Conclusion: The modified microcolumn gel method established in this study improves the detection sensitivity by changing the centrifuge mode and increased incubation time and incubation temperature of the microcolumn gel blood type card. It is suitable for screening ABO variant blood groups.
引文
[1]HOSOI E. Biological and clinical aspects of ABO blood group system[J]. J Med Invest, 2008, 55(3-4):174-182.
[2]YAZER M H, TRIULZI D J. Immune hemolysis following ABO-mismatched stem cell or solid organ transplantation.[J]. Curr Opin Hematol, 2007, 14(6):664-670.
[3]方建华,刘玉振,温涛.国产单克隆抗体试剂漏检Ax亚型1例[J].中国输血杂志, 2004, 17(2):119-119.
[4]迟晓云,闫萍,韩斌,等.微柱凝胶卡漏检B_w03亚型分析——附2例报告[J].中国输血杂志, 2016, 29(10):1147-1150.
[5]何卫社,刘乐霞,王德平,等.全自动血型仪漏检4例B(A)亚型原因分析[J].临床血液学杂志, 2016, 29(8):642-644.
[6]刘乐霞,肖玮,梁俊杰,等.国产单克隆血型试剂漏检B(A)血型分析[J].临床输血与检验, 2012, 14(4):333-334.
[7]李勇,杨贵贞.人类红细胞血型学实用理论与实验技术[M].北京:中国科学技术出版社, 1999, 267.
[8]刘秋菊,朱碎永,林甲进.类孟买型血清学特点及后续输血策略的研究[J].中国卫生检验杂志, 2017, 27(9):1276-1278.
[9]林晨蓓,王秀娣,朱碎永,等. A3亚型血型的血清学和分子生物学鉴定分析[J].中国卫生检验杂志, 2018, 28(7):801-802, 829.
[10]TITLESTAD K, GEORGSEN J, ANDERSEN H, et al. Detection of irregular red cell antibodies:more than 3 years of experience with a gel technique and pooled screening cells[J]. Vox Sang, 1997, 73(4):246-251.
[11]LANGSTON M M, PROCTER J L, CIPOLONE K M, et al.Evaluation of the gel system for ABO grouping and D typing[J]. Transfusion, 1999, 39(3):300-305.
[12]于洋,冯倩,林子林,等.全自动微柱凝胶技术在ABO、RhD血型鉴定中的应用研究[J].北京医学, 2008, 30(3):165-167.
[13]于海忠.微柱凝胶法在血型鉴定和交叉配血中的应用[J].临床和实验医学杂志, 2010, 9(6):453-454.
[14]李毅,佟力,董伟群,等.微柱凝胶卡法在血型检测中的应用[J].昆明医学院学报, 2010, 31(1):118-119, 126.
[15]肖倩,辛荣传,周益强,等.微柱凝胶法检测ABO疑难血型的临床应用及方法学探讨[J].中国实验诊断学, 2009,13(7):932-934.
[16]周小玉,许进明,华岚,等.微柱凝胶法鉴定ABO血型正反定型不一致原因分析[J].临床输血与检验, 2007, 9(4):366-367.
[17]邹纬,丁秋兰,王学锋.血型卡在血型鉴定中的局限性[J].诊断学理论与实践, 2005, 4(5):410-411.
[18]郭伟鹏,周吉霞,吐尔洪·克维尔,等.微柱凝胶法鉴定32例ABO亚型结果分析[J].临床血液学杂志(输血与检验),2015, 28(4):723-724.
[19]钟胜英.手工微柱凝胶免疫检验法在ABO、RhD血型抗原鉴定中的应用效果[J].实用中西医结合临床, 2017, 17(5):4-5.
[20]林海芬,谢作听,王春香.改良微柱凝胶法在鉴定ABO血型抗原明显减弱者中的应用[J].临床输血与检验, 2004,6(4):267-269.
[2]YAZER M H, TRIULZI D J. Immune hemolysis following ABO-mismatched stem cell or solid organ transplantation.[J]. Curr Opin Hematol, 2007, 14(6):664-670.
[3]方建华,刘玉振,温涛.国产单克隆抗体试剂漏检Ax亚型1例[J].中国输血杂志, 2004, 17(2):119-119.
[4]迟晓云,闫萍,韩斌,等.微柱凝胶卡漏检B_w03亚型分析——附2例报告[J].中国输血杂志, 2016, 29(10):1147-1150.
[5]何卫社,刘乐霞,王德平,等.全自动血型仪漏检4例B(A)亚型原因分析[J].临床血液学杂志, 2016, 29(8):642-644.
[6]刘乐霞,肖玮,梁俊杰,等.国产单克隆血型试剂漏检B(A)血型分析[J].临床输血与检验, 2012, 14(4):333-334.
[7]李勇,杨贵贞.人类红细胞血型学实用理论与实验技术[M].北京:中国科学技术出版社, 1999, 267.
[8]刘秋菊,朱碎永,林甲进.类孟买型血清学特点及后续输血策略的研究[J].中国卫生检验杂志, 2017, 27(9):1276-1278.
[9]林晨蓓,王秀娣,朱碎永,等. A3亚型血型的血清学和分子生物学鉴定分析[J].中国卫生检验杂志, 2018, 28(7):801-802, 829.
[10]TITLESTAD K, GEORGSEN J, ANDERSEN H, et al. Detection of irregular red cell antibodies:more than 3 years of experience with a gel technique and pooled screening cells[J]. Vox Sang, 1997, 73(4):246-251.
[11]LANGSTON M M, PROCTER J L, CIPOLONE K M, et al.Evaluation of the gel system for ABO grouping and D typing[J]. Transfusion, 1999, 39(3):300-305.
[12]于洋,冯倩,林子林,等.全自动微柱凝胶技术在ABO、RhD血型鉴定中的应用研究[J].北京医学, 2008, 30(3):165-167.
[13]于海忠.微柱凝胶法在血型鉴定和交叉配血中的应用[J].临床和实验医学杂志, 2010, 9(6):453-454.
[14]李毅,佟力,董伟群,等.微柱凝胶卡法在血型检测中的应用[J].昆明医学院学报, 2010, 31(1):118-119, 126.
[15]肖倩,辛荣传,周益强,等.微柱凝胶法检测ABO疑难血型的临床应用及方法学探讨[J].中国实验诊断学, 2009,13(7):932-934.
[16]周小玉,许进明,华岚,等.微柱凝胶法鉴定ABO血型正反定型不一致原因分析[J].临床输血与检验, 2007, 9(4):366-367.
[17]邹纬,丁秋兰,王学锋.血型卡在血型鉴定中的局限性[J].诊断学理论与实践, 2005, 4(5):410-411.
[18]郭伟鹏,周吉霞,吐尔洪·克维尔,等.微柱凝胶法鉴定32例ABO亚型结果分析[J].临床血液学杂志(输血与检验),2015, 28(4):723-724.
[19]钟胜英.手工微柱凝胶免疫检验法在ABO、RhD血型抗原鉴定中的应用效果[J].实用中西医结合临床, 2017, 17(5):4-5.
[20]林海芬,谢作听,王春香.改良微柱凝胶法在鉴定ABO血型抗原明显减弱者中的应用[J].临床输血与检验, 2004,6(4):267-269.