微量血检测红细胞表面抗体诊断小儿自身免疫性溶血性贫血研究

Micro Blood Sample for RBC Surface Antibody in the Diagnosis of Childhood Autoimmune Hemolytic Anemia

摘要:

目的： 采用微量血检测自身免疫性溶血性贫血(AIHA)患儿的红细胞表面抗体,对其方法学与诊断学进行探讨。方法： 对145例疑为AIHA患儿用微量方法检测直接Coombs试验及红细胞表面单价抗体,并对其中30例病人进行了静脉血脱纤维蛋白后的Coombs试验,对两种方法进行比较。结果： 145例标本共检出AIHA 13例 ,所有患者Coombs试验阳性,其中单价抗体IgG阳性有7例,IgG +C31例 ,IgG +IgM +C33例,IgM +C32例。同时对30例检测对象进行了微量血与脱纤维蛋白血的对比,其中 4例阳性者,两种检测方法一致;2 6例阴性结果中微量血假阳性率3.85% ,脱纤维蛋白血假阳性率为7.69%,二者差异无统计学意义(P>0.05)。对两种方法洗涤后红细胞上清液分析显示,3次洗涤后上清液中所含总蛋白差异无显著性(P>0.05)。结论： 用微量血检测红细胞表面抗体诊断AIHA与静脉脱纤维蛋白血检测结果基本一致,采血少,操作方便,且易于复查

Abstract:

OBJECTIVE: To study the significance of the micro blood sample for surface antibody of red blood cells (RBC) in the diagnosis of childhood autoimmune hemolytic anemia (AIHA). METHODS: The RBC surface antibody was measured in 145 children with suspected AIHA using the micro blood sample. Of them, 30 cases, besides using the micro blood sample, were measured using the routine method -- the direct Coombs test by taking venous blood of defibrinogen at the same time. RESULTS: Of the 145 patients 13 were diagnosed AIHA by the micro blood sample. The direct Coombs test was positive in the 13 cases. Seven of them had a positive result with univalent antibody IgG, 1 with IgG+C3, 3 with IgG+IgM+C3 and 2 with IgM+C3. In 30 cases with the two tests for the RBC surface antibody, 4 had a positive result with the direct Coombs test. The results of the two methods were consistent. In 26 negative cases, there was a false positive ( 3.85% ) of univalent antibody IgM by the minim finger blood test, and 2 false positive ( 7.69% ) of IgM using the routine method. There was no statistic difference between the two methods (P> 0.05 ). No difference was noted in the protein of supernatant fluid after centrifugation between the two methods (P> 0.05 ). CONCLUSIONS: The micro blood sample for RBC surface antibody in the diagnosis of childhood AIHA is reliable and convenient for re test.