抗-D抗体的定量测定与效价测定的比较性研究

目的Rh系统血型同种抗体是造成严重新生儿溶血疾病的最主要因素。在发达国家和地区,RhD同种抗体监测通常使用抗体定量方法,而在我国通常采用效价测定方法。本研究针对效价测定法与抗体定量法的相关性进行比较,研究效价测定法是否可以真实反映抗体效力。方法本研究中,对17份效价大于64的抗-D血浆样本的效价与抗体定量法进行比较研究,效价法采用ORTHOVISION自动血型检测仪进行自动凝胶柱法检测,抗体定量采用自动连续流抗体定量仪(WHS-D0120)进行检测。结果通过研究,本研究团队发现,抗体效价法与抗体定量法并不是总一致,其相关性为r=0.92(P<0.001),通过对n≥3的效价组(256组、512组、2048组)的比较研究发现,256组与512组间差异有统计学意义(P<0.001),256组与2048组间及512组与2048组间差异无统计学意义(P>0.05),通过单核细胞单层实验,发现效价为256的四份抗体血浆吞噬率组存在较大差异。结论对RhD阴性的患者及孕妇血浆的抗-D评估及监测,抗体定量法较效价法更为精确。

Comparative Study on Quantitative and Titer Determination of Anti-D Antibody

Objective IgG anti-D is the main cause of severe hemolytic disease in newborns.The continuous-flow antibody quantifier has been widely used in Europe,North America and Australia.In China it is usually tested and recorded by titer assay in pregnant women and patients’antiserum.This study mainly compares the correlation between the titer assay and the antibody quantification method,and studies whether the titer assay can represent the amount of antibody.Methods In this study,17 plasma samples with anti-D titer greater than 64 were compared with the antibody quantification method.The titer method was performed by ORTHOVISION automatic blood type detector for automatic gel column detection.The automatic continuous flow antibody quantizer(WHS-D0120)was used for quantification.Results It was found that the correlation between antibody titer and antibody quantification was r=0.92(P<0.001).The comparative study between the titer groups of n≥3(256 groups,256 groups,2048 groups),found that there was a statistically significant difference between the 256 and 512 groups(P<0.001),and there was no statistical difference between the 256 and 2048 groups,or between the 512 and 2048 groups(P>0.05).In the mononuclear monolayer assay,it was found that there were large phagocytosis differences between the four antibody samples of anti-plasma group with a titer of 256.Conclusion For the anti-D assessment and monitoring of Rh-negative patients and pregnant women’s plasma,quantification is more accurate than the titer assay.