Consideration on missed detection of anti-M antibody caused by dose effect of screening cells
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摘要: 目的 通过对1例M抗原杂合子筛选细胞造成不规则抗体筛查假阴性病例的思考，指导不规则抗体筛选细胞、交叉配血方法的选择和手术备血流程的注意事项。方法 分别选择筛选细胞A、B用微柱凝胶法对同一样本进行不规则抗体筛查；分别用微柱凝胶法和聚凝胺法对同一组样本进行交叉配血。结果 应用筛选细胞A的不规则抗体筛查结果为阴性，筛选细胞B的不规则抗体筛查为阳性，北京市红十字血液中心抗体鉴定结果为抗-M抗体，说明筛选细胞A检测结果为假阴性。微柱凝胶法交叉配血不合，聚凝胺法交叉配血相合。结论 筛选细胞中存在杂合子会造成不规则抗体筛查假阴性，因此在选择筛选细胞时尽量选择抗原多且纯合子的筛选细胞；在抗体效价较低时聚凝胺法检测结果可能出现假阴性，所以有妊娠史和输血史的患者配血时应尽量选择敏感性较好的微柱凝胶法来检测。Abstract: Objective To guide the selection of irregular antibody screening cells, cross matching methods and precautions for surgical blood preparation through thinking about a case of false negative of irregular antibody screening caused by screening cells of M antigen heterozygotes.Methods Screening cells A and B were selected to screen the same sample for irregular antibody by microcolumn gel method. The same group of samples were cross matched by microcolumn gel method and polybrene method.Results The irregular antibody screening result of screening cell A was negative, the screening cell B was positive, and the antibody identification result of Beijing Red Cross Blood Center was anti-M antibody, indicating that the test result of screening cells A was false negative. Cross matching of micro column gel method was incompatible, and polybrene method was compatible.Conclusion The presence of heterozygotes in the screening cells would cause false negative of irregular antibody screening, so the screening cells with more antigens and homozygotes should be selected as much as possible when selecting the screening cells. When the antibody titer is low, false negative results may appear in the test results of the polyclonal amine method. Therefore, the patients with a history of pregnancy and blood transfusion should try to select the micro column gel method with better sensitivity for blood matching.
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Key words:
- heterozygote /
- dose effect /
- irregular antibody /
- micro ink gel method /
- polyamine method
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表 1 2种筛选细胞的抗原表达及患者反应格局
序号 Rh-Hr KELL DUFFY KIDD Xg LEWIS MNS P LU 患者 D C E c e K k Kpa Kpb Fya Fyb Jka Jkb Xga Lea Leb M N S s P1 Lua Lub 筛选细胞A Ⅰ + 0 + + 0 / / / / + 0 / / / 0 + + + 0 + + / / - Ⅱ + + 0 0 + / / / / + 0 / / / + + 0 + 0 + + / / - Ⅲ + + + + + / / / / + 0 / / / 0 + + + + + + / / - 筛选细胞B Ⅰ + + 0 0 + + + 0 + + + 0 + + + 0 + 0 + + + 0 + 1+ Ⅱ + 0 + + 0 0 + 0 + + 0 + 0 0 0 0 + 0 + + 0 0 + 1+ Ⅲ 0 0 0 + + 0 + 0 + 0 + + 0 + 0 + + + + 0 + 0 + ± 北京市红十字血液中心抗体鉴定结果抗-M抗体/为筛选细胞无此抗原信息。 
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