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目的 探讨葛根素中毒的致病机制。方法 采用血液免疫学体外药物模拟抗球蛋白实验。直接抗球蛋白试验(DAT)检测患者RBC(Pc)上的免疫复合物;间接抗球蛋白实验(IAT)检测试剂红细胞(Dc)被患者血清(Ps)、葛根素、补体在37℃孵育后及间接抗球蛋白实验中有否凝集或溶血。结果4例红细胞DAT均阳性;间接抗蛋白实验:Dc经4例Ps、3种浓度葛根素在37℃孵育后均凝集;在IAT洗涤过程中被例1 Ps孵育的Dc部分溶血;在用抗球蛋白试剂(AGS)检测中,Dc与3种特异性AGS均凝集;Dc单独与葛根素孵育不凝集;不加药物的Ps组及加入药物的Ds组均不凝集。结论患者血清中含有可活化补体的IgM类抗葛根素抗体,此为急性血管内溶血、肾衰的病理基础。
Objective To investigate the pathogenesis of puerarin poisoning. Methods In vitro anti-globulin experiments were performed using blood immunology. Direct immunoglobulin test (DAT) was used to detect the immunocomplexes on RBC (Pc); indirect antibody test (IAT) reagent erythrocytes (Dc) was incubated with Ps, puerarin and complement at 37 ℃ And indirect antiglobulin experiments whether agglutination or hemolysis. RESULTS: All of the 4 erythrocytes were positive for DAT. Indirect anti-protein assay: Dc was agglutinated by 4 Ps and 3 puerarin incubated at 37 ℃. Dc partially incubated with 1 Ps in IAT washing process was hemolysis. Globulin reagent (AGS) test, Dc and 3 kinds of specific AGS are agglutinated; Dc alone and puerarin incubation did not agglutinate; drug-free Ps group and the drug-added Ds group did not agglutinate. Conclusions Serum contains IgM anti-puerarin antibody that can activate complement, which is the pathological basis of acute intravascular hemolysis and renal failure.