Garratty G, Nance S J
American Red Cross Blood Services, Los Angeles-Orange Counties Region, California.
Transfusion. 1990 Sep;30(7):617-21. doi: 10.1046/j.1537-2995.1990.30790385519.x.
A flow cytometry method was used to compare the amount of red cell (RBC)-bound IgG in 73 patients with and without immune hemolytic anemia (IHA). The positive results in 10 of the direct antiglobulin tests (DATs) were idiopathic, and those in 25 were due to methyldopa therapy; 38 of the 73 DAT-positive patients were babies born to women with IgG alloantibodies of potential clinical significance. Normal blood donors with (n = 30) and without (n = 121) positive DATs were also tested. RBCs that had been strongly sensitized (4+ indirect antiglobulin test) in vitro with different quantities of IgG anti-D, but that had similar antiglobulin test (AGT) titration scores, could easily be differentiated by flow cytometry. The mean percent fluorescence of RBCs, incubated with fluorescein-labeled anti-IgG, from neonatal patients with IHA was higher than that of RBCs from those without IHA, but there was no statistical difference in the other groups. There was considerable overlap in the respective ranges of percent fluorescence of RBCs from patients with and without IHA in all groups. It was not possible to define a clear quantitative threshold differentiating patients with IHA from those without. Although flow cytometry was more precise and reproducible than standard serology (e.g., AGT titration scores), correlations of the amount of RBC-bound IgG and in vivo hemolysis were similar.
采用流式细胞术方法比较73例有或无免疫性溶血性贫血（IHA）患者红细胞（RBC）结合IgG的量。10例直接抗球蛋白试验（DAT）阳性结果为特发性，25例为甲基多巴治疗所致；73例DAT阳性患者中有38例是具有潜在临床意义的IgG同种抗体的女性所生婴儿。对直接抗球蛋白试验阳性（n = 30）和阴性（n = 121）的正常献血者也进行了检测。体外经不同量IgG抗-D强烈致敏（间接抗球蛋白试验4+）但抗球蛋白试验（AGT）滴定分数相似的红细胞，可通过流式细胞术轻松区分。与荧光素标记的抗IgG孵育的IHA新生儿患者红细胞的平均荧光百分比高于无IHA患者的红细胞，但其他组无统计学差异。所有组中有或无IHA患者红细胞荧光百分比各自的范围有相当大的重叠。无法确定区分有IHA患者和无IHA患者的明确定量阈值。尽管流式细胞术比标准血清学（如AGT滴定分数）更精确且可重复，但RBC结合IgG量与体内溶血的相关性相似。
