Sebring E S, Polesky H F
Transfusion. 1982 Nov-Dec;22(6):468-71. doi: 10.1046/j.1537-2995.1982.22683068604.x.
Current serologic tests occasionally fail to identify women needing more than one vial of Rh immune globulin. We compared the indirect antiglobulin test after incubation with anti-D and a rosetting technique using enzyme treated Rh2Rh2 erythrocytes as methods for identifying significant fetal maternal hemorrhage (FMH). Artificial mixtures containing 0.05 to 1.2 percent Rh1rh (CcDe) fetal red blood cells mixed with rh (ce) adult red blood cells were tested. The indirect antiglobulin test of the 0.6 percent mixture (approximately 30 ml FMH) was reported to be microscopically positive by 17/20 technologists; whereas, 20/20 found the rosetting test to be strongly positive. The volume of FMH in 118 postpartum Rh immune globulin candidates was quantified using Kleihauer's test and formula. The results of the rosetting and Kleihauer tests of blood specimens from these patients were negative 1.4 ml for two, and strongly positive rosetting test and FMH of 6.5 ml for one. The rosetting test utilizes routine blood banking skills and requires 5 minutes more "hands on" time than an indirect antiglobulin test. Confirmation and quantification of positive results by an acid-elution test is necessary.
目前的血清学检测偶尔无法识别出需要不止一剂Rh免疫球蛋白的女性。我们比较了抗-D孵育后的间接抗球蛋白试验和使用酶处理的Rh2Rh2红细胞的玫瑰花结技术，作为识别显著胎儿-母体出血（FMH）的方法。对含有0.05%至1.2% Rh1rh（CcDe）胎儿红细胞与rh（ce）成人红细胞混合的人工混合物进行了检测。据报告，17/20的技术人员显微镜下观察到0.6%混合物（约30 ml FMH）的间接抗球蛋白试验呈阳性；而20/20的人发现玫瑰花结试验呈强阳性。使用克莱豪尔试验和公式对118名产后Rh免疫球蛋白候选者的FMH量进行了定量。这些患者血液标本的玫瑰花结试验和克莱豪尔试验结果中，有两例FMH为1.4 ml，结果为阴性，有一例玫瑰花结试验呈强阳性，FMH为6.5 ml。玫瑰花结试验利用常规血库技术，比间接抗球蛋白试验需要多5分钟的“实际操作”时间。阳性结果需要通过酸洗脱试验进行确认和定量。
