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目的对随机献血者及临床输血患者红细胞、血小板、淋巴细胞与中性粒细胞的抗体进行固相化联合筛查体系。方法将单层混合多人份血细胞分别固定在U型微孔板中,制备出固相化抗体筛查体系。然后对随机献血样本2 150例及临床输血患者输血后样本440例血浆中是否含有相应抗体进行检测,并分析对对输血后效果的影响。结果随机献血者样本中抗体筛出率为:红细胞抗体53例(2.5%),血小板抗体22例(1%),淋巴细胞抗体13例(0.6%),中性粒细胞抗体55例(2.6%);临床输血患者输血后样本中抗体筛出率为:红细胞抗体31例(7%),血小板抗体38例(8.6%),淋巴细胞抗体24例(5.5%),中性粒细胞抗体43例(7.5%),混合抗体(包括同时存在两种或两种以上抗体)115例(26.1%)。223次(22.8%)输血后产生疑似不良反应,其中133例(约60%)检出抗体阳性。结论血细胞抗体固相化筛查体系可应用于临床输血前及输血后抗体检测。固相化检测体系灵敏度高于试管法血清学检测与流式细胞术。抗体的存在对输血效果存在一定的影响。
Objective To carry out the solid phase screening system for erythrocytes, platelets, lymphocytes and neutrophils in random blood donors and clinical transfusion patients. Methods Monolayer mixed multi-donor blood cells were fixed in U-shaped microplate, prepared a solid phase antibody screening system. Then, the blood samples of 2 150 random blood donation samples and 440 blood transfusion samples of clinical transfusion patients were tested for the presence or absence of the corresponding antibodies, and the effect on blood transfusion was analyzed. Results The screening rate of antibodies in random blood donors was 53 cases (2.5%) of erythrocytes, 22 cases of platelet antibodies (1%), 13 cases of lymphocyte antibodies (6%), 55 cases of neutrophil antibodies (2.6% ). The antibody screening rate in transfused patients was 31 cases (7%) of erythrocytes, 38 cases (8.6%) of platelet antibodies, 24 cases of lymphocyte antibodies (5.5%) and 43 cases of neutrophil antibodies (7.5%), and 115 (26.1%) were mixed antibodies (including two or more antibodies simultaneously). 223 (22.8%) transfusions produced suspected adverse reactions, of which 133 (about 60%) were positive for antibodies. Conclusion The screening system for blood cell antibodies can be applied to the detection of antibodies before transfusion and after transfusion. The sensitivity of the solid phase detection system is higher than that of the test tube serological test and flow cytometry. The presence of antibodies has a certain impact on blood transfusion.