Abstract: Objective: To explore the influencing factors and clinical significance of the direct antiglobulin test(DAT) positive agglutination intensity.Methods: A total of 182 cases of DAT-positive specimens were tested for antibody strength and antibody and complement typing tests by using microcolumn gel anti-human globulin card, and the efficiency of DAT positive patients with different antibody strengths was compared after transfusion.Results: The autoimmune hemolytic anemia and systemic lupus erythematosus agglutination intensity of 3 to 4+in 182 DAT-positive patients were 85.7% and 76.2%, respectively, which was higher than other diseases. With the increase of the number of blood transfusions, the agglutination intensity of DAT-positive patients also increased significantly; the agglutination intensity of DAT-positive patients with severe anemia was 3-4+accounting for 87.5%, while the patients with mild anemia only accounted for 13.5%. Simple C3 d DAT positive agglutination intensity 3-4+was 9.1%, while composite IgG+IgM+C3 d+C3 c DAT positive agglutination intensity 3-4+accounted for 71.4%. The comparison of hemoglobin value(Hb) before and after blood transfusion among DAT-positive patients with different agglutination intensities found that the increase in agglutination intensities between 3 and 4+groups was significantly lower than that in the 1+group, the difference was statistically significant(P<0.01).Conclusion: The intensity of agglutination in DAT-positive patients may be correlated with the type of disease, the number of blood transfusions, the degree of anemia, and the type of antibodies and complement. And the therapeutic effect of DAT positive patients may have a certain relationship with the strength of antibodies. Therefore, the intensity of antibody agglutination in DAT-positive patients may have important reference significance for the treatment effect and prognosis of anemia patients.