诊断学理论与实践

诊断学理论与实践 ›› 2019, Vol. 18 ›› Issue (06): 672-675.doi: 10.16150/j.1671-2870.2019.06.013

• 论著 • 上一篇    下一篇

微柱凝胶技术在临床安全输血中的应用

金燕萍(), 江铭, 贾方明   

  1. 上海交通大学医学院附属瑞金医院卢湾分院放免检验科,上海 200020
  • 收稿日期:2019-08-09 出版日期:2019-12-25 发布日期:2019-12-25
  • 通讯作者: 金燕萍 E-mail:lw41010jyp@rjlwh.com.cn

Application of microcolumn gel technique in safe blood transfusion

JIN Yanping(), JIANG Ming, JIA Fangming   

  1. Department of Radioimmunoassay Laboratory, Ruijin Hospital, Luwan Branch, Shanghai Jiao Tong University School of Medicine,Shanghai 200020, China
  • Received:2019-08-09 Online:2019-12-25 Published:2019-12-25
  • Contact: JIN Yanping E-mail:lw41010jyp@rjlwh.com.cn

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摘要：

目的：探讨微柱凝胶技术在临床安全输血中的应用价值。方法：选取2014年7月至2019年6月间本院需要进行输血治疗的患者6 630例,采用微柱凝胶法进行不规则抗体筛查和交叉配血试验,同时将结果与凝聚胺法结果进行比较。结果：6 630例患者用微柱凝胶法进行抗体筛查,共检出不规则抗体35例,检出率为0.53%;而采用凝聚胺法进行检测,不规则抗体检出率为0.39%（26/6 630）,2种方法间的不规则抗体检出率差异无统计学意义（P>0.05）。6 630例患者用微柱凝胶法进行交叉配血,不合率为0.72%（48/6 630）;用凝聚胺进行法交叉配血,不合率为0.45%（30/6 630）,2种方法间的差异有统计学意义（P<0.05）;交叉配血不合共有49例,微柱凝胶法交叉配血试验不合48例,1例只在凝聚胺法配血不合,经抗体鉴定未确定其特异性,微柱凝胶法交叉配血试验的灵敏度为97.96%（48/49）,明显高于凝聚胺法[61.22%(30/49）],差异有统计学意义P<0.05）。结论：微柱凝胶技术的检测灵敏度高,易于标准化,结果清晰、准确,易于判读,对于保证临床输血安全有重要价值,但凝聚胺法检测快速、简单,也有较高的灵敏度,适用于急诊抢救患者的配血。条件允许时,可同时采用2种方法互为验证,真正确保输血的安全性和有效性。

关键词: 交叉配血, 微柱凝胶技术, 凝聚胺法, 血型不规则抗体

Abstract:

Objective: To study the value of microcolumn gel technique in safe blood transfusion. Methods: Altogether 6 630 patients who needed blood transfusion from July 2014 to June 2019 were selected for irregular antibody screening and cross matching test by microcolumn gel method, and the results were compared with those of the polybrene method. Results: All 6 630 patients were screened by microcolumn gel method, and 35 cases had irregular antibody detected, the detection rate of irregular antibody was 0.53% (35/6 630); whereas the detection rate of irregular antibody by polybrene method was 0.39%(26/6 630), there was no significant difference between the two methods (P>0.05). All 6 630 patients were cross-matched by microcolumn gel method, the failure rate was 0.72% (48/6 630); when cross-matched by polybrene method, the failure rate was 0.45% (30/6 630); the difference between the two methods was statistically significant (P<0.05). Of the 49 cases with failure of cross-matching, the cross-test by microcolumn gel method showed failure in 48 cases; 1 case was showed by the polybrene method only, antibody identification had not revealed the specificity. The sensitivity of cross matching by microcolumn gel method was 97.96% ( 48/49), which was significantly higher than that by polybrene method (61.22%, 30/49). The difference was statistically significant (P<0.05). Conclusions: The microcolumn gel technology has high sensitivity, easy for standardization, with clear and accurate results, easy for interpretation, and has important application value for ensuring safety of blood transfusion. However, the polybrene method is rapid and simple, also has high sensitivity, and is suitable for emergency treatment. Appropriate method should be selected according to patient's condition on the premise of ensuring the safety of blood transfusion. Conditions allowing the two methods to verify each other would ensure the safety and effectiveness of blood transfusion.

Key words: Cross matching, Microcolumn gel technique, Polybrene method, Irregular blood group antibody

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