Zeiler T, Thiele S, Kretschmer V
Abteilung für Transfusionsmedizin und Gerinnungsphysiologie, Philipps-Universität Marburg, Deutschland.
Beitr Infusionsther Transfusionsmed. 1996;33:17-21.
To define differences of specifity and sensitivity between a solid phase- and a gel centrifugation test for detection of irregular erythrocyte antibodies.
3052 blood samples were screened for erythrocyte antibodies (AB) by gel centrifugation [ID-System, (ID) 37 degrees C Bromelin and indirect antiglobulin test with LISS (IAT)] and a solid phase antiglobulin test [Capture-R Ready Screen (CR)] in a prospective study. Identical test cells were used as immobilized monolayer in CR and as 1%-suspension in ID. Additionally, 42 sera with antibodies reacting in both tests were titered geometrically in both techniques.
In 79 (2.6%) of all sera tested, irregular erythrocyte antibodies were detected. 64 (81%) of these positive sera were detected by both tests, 73 (92.3%) by ID and 70 (88.4%) by CR. 6 sera with AB (7.6%) were positive only with CR (1 Ce, 1 E, 1 Leb, 1 C, 1 D, 1 Cob) and 9 (11.4%) only with ID (4 Lea, 1 Fya, 1 C, 2 P1, 1 D). Seven AB solely detected in ID only reacted in the bromelin test, besides an anti-Fya, which was an IgM antibody. The titration of IgG antibodies showed a slightly higher sensitivity of the CR (less than one titre step). The ID showed clearly more unspecific reactions (1.1%) than the CR (0.5%).
The antibody screening with the ID proved to detect more AB than the CR (mainly due to certainly irrelevant "enzyme only" AB). On the other hand, relevant IgG AB were detected more sensitive by the CR. Unspecific reactions appeared clearly more often in ID, predominantly when using the bromelin test. Missing a strong IgM anti-Fya in the CR is certainly a concern because of its assumed haemolytic activity. Therefore CR for antibody screening should always be combined with a method for crossmatching that safely detects IgM antibodies which are relevant for transfusion.
确定用于检测不规则红细胞抗体的固相试验和凝胶离心试验在特异性和敏感性方面的差异。
在一项前瞻性研究中，采用凝胶离心法[ID系统，（ID）37℃菠萝蛋白酶和含低离子强度盐溶液的间接抗球蛋白试验（IAT）]和固相抗球蛋白试验[捕获-R快速筛查（CR）]对3052份血样进行红细胞抗体（AB）筛查。相同的检测细胞在CR中用作固定化单层，在ID中用作1%悬浮液。此外，对在两种试验中均有反应的42份含抗体血清在两种技术中进行几何滴定。
在所有检测的血清中，79份（2.6%）检测到不规则红细胞抗体。这些阳性血清中，64份（81%）在两种试验中均被检测到，73份（92.3%）在ID试验中被检测到，70份（88.4%）在CR试验中被检测到。6份含AB的血清（7.6%）仅在CR试验中呈阳性（1份抗Ce、1份抗E、1份抗Leb、1份抗C、1份抗D、1份抗Cob），9份（11.4%）仅在ID试验中呈阳性（4份抗Lea、1份抗Fya、1份抗C、2份抗P1、1份抗D）。仅在ID试验中检测到的7种AB中，除一种IgM类抗Fya抗体外，其余仅在菠萝蛋白酶试验中有反应。IgG抗体的滴定显示CR的敏感性略高（相差不到一个滴度步骤）。ID试验显示的非特异性反应（1.1%）明显多于CR试验（0.5%）。
ID试验进行抗体筛查时检测到的AB比CR试验更多（主要是由于一些肯定无关的“仅酶反应”AB）。另一方面，CR试验对相关IgG AB的检测更敏感。ID试验中出现的非特异性反应明显更频繁，主要是在使用菠萝蛋白酶试验时。CR试验未能检测到强IgM抗Fya抗体，鉴于其假定的溶血活性，这肯定是一个问题。因此，用于抗体筛查的CR试验应始终与一种能安全检测与输血相关的IgM抗体的交叉配血方法相结合。
