Bromilow I M, Duguid J K
National Blood Service, Mersey and North Wales, Liverpool, UK.
Clin Lab Haematol. 1997 Jun;19(2):137-42. doi: 10.1046/j.1365-2257.1997.00216.x.
In the UK a Kleihauer test is routinely performed on all RhD-negative women after the birth of an RhD-positive child to ensure that an adequate dose of anti-D immunoglobulin is given. The results of Kleihauer testing are interpreted to assess the volume of any feto-maternal haemorrhage and additional anti-D immunoglobulin is administered if necessary. A similar procedure is followed ante-natally when incidents occur known to be associated with alloimmunization. The performance of Kleihauer tests is difficult to standardize and there can be problems in interpreting the volume of feto-maternal haemorrhage. The use of flow cytometry to measure feto-maternal haemorrhage is reported to give more accurate and reliable results. This study compared three different Kleihauer methods and two different flow cytometry techniques all performed using the same maternal sample and within a single laboratory. The results demonstrated variability between the Kleihauer tests used and also in the flow cytometry measurements. A well-performed Kleihauer test would still appear to be useful as a screening technique for detection of feto-maternal haemorrhage. However, accurate quantitation of size of feto-maternal haemorrhage is more reliably determined by flow cytometry.
在英国，所有RhD阴性的女性在分娩出RhD阳性的孩子后，都会常规进行一项酸处理后血涂片检查（Kleihauer test），以确保给予足够剂量的抗-D免疫球蛋白。酸处理后血涂片检查的结果用于评估任何胎儿-母体出血的量，如有必要会给予额外的抗-D免疫球蛋白。当发生已知与同种免疫相关的事件时，产前也遵循类似的程序。酸处理后血涂片检查的操作难以标准化，并且在解释胎儿-母体出血的量时可能会出现问题。据报道，使用流式细胞术测量胎儿-母体出血能得到更准确可靠的结果。本研究比较了三种不同的酸处理后血涂片检查方法和两种不同的流式细胞术技术，所有操作均使用相同的母体样本且在同一实验室进行。结果表明，所使用的酸处理后血涂片检查之间以及流式细胞术测量之间存在差异。一项操作良好的酸处理后血涂片检查似乎仍可作为检测胎儿-母体出血的筛查技术。然而，胎儿-母体出血大小的准确量化通过流式细胞术能更可靠地确定。
