Judd W J, Steiner E A, Oberman H A, Giacherio D
Department of Pathology, University of Michigan Medical Center, Ann Arbor.
Transfusion. 1988 Jul-Aug;28(4):339-41. doi: 10.1046/j.1537-2995.1988.28488265262.x.
Thirteen of 1450 (0.9%) Rh-negative samples submitted for pretransfusion or prenatal testing gave weak false-positive reactions in immediate-spin (IS) tests with chemically modified anti-D (CM-D). Only seven reacted in control tests with anti-A and/or -B. The other six samples could have been considered Rh positive; however, such a conclusion is inappropriate, since stronger (greater than or equal to 3+) reactions are expected in IS tests with CM-D and the vast majority of true Rh-positive blood samples. Moreover, three of the six false-positive CM-D reactions associated with negative control tests were from patients previously found to be Rh negative. The other three samples gave 1+ to 2+ reactions with CM-D and did not react with anti-A and/or -B; these erroneous CM-D reactions were recognized by confirmatory tests with high-protein anti-D and Rh control reagents that were performed because previous typing results were not on file. Such confirmation, as well as careful grading and proper interpretation of serologic reactions, serves to prevent erroneous Rh typing without the use of a separate, immunologically inert Rh control reagent.
在提交进行输血前或产前检测的1450份Rh阴性样本中，有13份（0.9%）在与化学修饰抗-D（CM-D）进行即刻离心（IS）试验时出现弱阳性假阳性反应。在与抗-A和/或抗-B的对照试验中，只有7份有反应。其他6份样本原本可能会被认为是Rh阳性；然而，这样的结论并不恰当，因为在使用CM-D进行的IS试验以及绝大多数真正的Rh阳性血样中，预期会出现更强（大于或等于3+）的反应。此外，与阴性对照试验相关的6例假阳性CM-D反应中有3份来自之前被认定为Rh阴性的患者。另外3份样本与CM-D出现1+至2+反应，且与抗-A和/或抗-B无反应；由于之前的血型检测结果未存档，因此通过使用高蛋白抗-D和Rh对照试剂进行确证试验识别出了这些错误的CM-D反应。这样的确证，以及对血清学反应的仔细分级和正确解读，有助于在不使用单独的、免疫惰性的Rh对照试剂的情况下防止错误的Rh血型鉴定。
