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目的研究自身免疫性溶血性贫血(AIHA)的诊断方法。方法采用直接抗IgG试验及热放散试验,以检查贫血患者红细胞上结合的自身抗体;采用抗体筛选试验及DL试验,以检查贫血患者血液中游离的自身抗体;采用直接抗C3d试验,以检查贫血患者红细胞上结合的补体C3d片段。将上述试验结果联合运用,以诊断贫血患者中的各类AIHA患者。结果在239例贫血患者中,共诊断出46例贫血患者为AIHA患者,诊断率为19.25%;在诊断出的AIHA患者中,温型AIHA患者占27例(15男12女)、混合型AIHA患者占8例(5男3女)及冷凝素综合症(CAS)患者占11例(6男5女);239例贫血患者按性别分类,在102例男性及137例女性贫血患者中,分别诊断出26例男性及20例女性贫血患者为AIHA患者,诊断率分别为25.49%及14.60%,两者比较有显著性差异(χ~2=4.463,P<0.05)。结论采用若干免疫血液学试验联合运用,可正确诊断贫血患者中的各类AIHA患者。
Objective To study the diagnostic methods of autoimmune hemolytic anemia (AIHA). Methods A direct anti-IgG test and a thermal elution test were used to examine the autoantibodies bound to erythrocytes in patients with anemia. Antibody-screening tests and DL tests were performed to examine the free autoantibodies in the blood of patients with anemia. Direct anti-C3d tests were performed to detect anemia Patient erythrocytes bound complement C3d fragment. The above test results were combined to diagnose various AIHA patients in anemia patients. Results Of 239 anemia patients, 46 anemia patients were diagnosed as AIHA with a diagnosis rate of 19.25%. Among the AIHA patients diagnosed, 27 (15 males and 12 females) with AIHA, mixed AIHA The patients accounted for 11 cases (6 males and 5 females) in 8 cases (5 males and 3 females) and condensing syndrome (CAS) patients. 239 anemia patients were classified by gender, among 102 males and 137 females with anemia, respectively The diagnosis of AIHA in 26 males and 20 females with anemia was diagnosed as 25.49% and 14.60%, respectively, with significant difference (χ ~ 2 = 4.463, P <0.05). Conclusions A combination of several immunological hematology tests can correctly diagnose all types of AIHA in patients with anemia.