Braga G W, Bordin J O, Moreira Júnior G, Kuroda A
Disciplina de Hematologia e Hemoterapia, Universidade Federal de São Paulo-Escola Paulista de Medicina.
Rev Assoc Med Bras (1992). 1998 Jan-Mar;44(1):16-20. doi: 10.1590/s0104-42301998000100004.
The direct manual Polybrene test (DPT) and the direct antiglobulin tests (DAT) were employed to detect antibody sensitizing red blood cell (RCB) in patients with clinical and laboratorial findings of autoimmune hemolytic anemia (AIHA).
To compare the sensitivity and specificity of DPT and DAT in the diagnosis of AIHA.
Eighteen consecutive patients with diagnosis of AIHA were evaluated. The control group consisted of 20 normal volunteers blood donors and 20 patients with sickle cell anemia. All patients and controls were submitted to DPT and DAT. All DAT positive samples were further tested using monospecific reagents (anti-IgG heavy chain and anti-C3d). Positive samples for either DPT or DAT were evaluated by eluate technique using. The dichloromethane (DCM).
The DAT was positive in 14 patients and negative in 4 subjects, while the DPT was positive in 17 patients and negative in 1 individual who had a positive DAT owing to complement (C3d). All positive eluates performed with DCM showed RBC autoantibodies with presumed "anti-Rh" specificity. The sensitivity rate of the DPT (94%) was significantly (p < 0.05) higher than the sensitivity rate of DAT (78%) to determine whether IgG was bound in vivo, but no difference was found regarding the specificity of the two tests.
采用直接手工聚凝胺试验（DPT）和直接抗球蛋白试验（DAT）检测自身免疫性溶血性贫血（AIHA）患者中致敏红细胞（RCB）的抗体。
比较DPT和DAT在AIHA诊断中的敏感性和特异性。
对18例连续诊断为AIHA的患者进行评估。对照组由20名正常志愿者献血者和20例镰状细胞贫血患者组成。所有患者和对照均接受DPT和DAT检测。所有DAT阳性样本均使用单特异性试剂（抗IgG重链和抗C3d）进一步检测。DPT或DAT阳性样本采用二氯甲烷（DCM）洗脱技术进行评估。
14例患者DAT阳性，4例阴性；17例患者DPT阳性，1例因补体（C3d）导致DAT阳性的个体DPT阴性。所有用DCM进行的阳性洗脱液均显示出具有推测“抗Rh”特异性的红细胞自身抗体。在确定IgG是否在体内结合方面，DPT的敏感性率（94%）显著高于DAT（78%）（p<0.05），但两种检测的特异性无差异。
1）在检测AIHA患者红细胞上的IgG自身抗体方面，DPT比DAT更敏感；2）由于其简单快速，DPT是用于筛查Coombs阴性AIHA的有用附加检测方法。
