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大多数自身免疫性溶血性贫血(AIHA)的病人在红细胞上存在免疫球蛋白和/或补体,可通过直接抗人球蛋白试验(Coombs试验)加以证实。此种免疫球蛋白为抗红细胞抗体大多系IgG,少数系IgG亚型(IgG1~4)、IgM和IgA。据抗体结合补体消耗试验测定正常情况下每个红细胞上所包绕的IgG分子数不超过25个。据报导有2~4%的自身免疫性溶血性贫血病人直接Coombs试验阴性。其原因有如下几点分析。 1.红细胞上抗体的浓度直接Coombs试验阴性大多由于受检者红细胞上自身抗体的浓度低于试验的检出水平。出现阳性在每个红细胞上所需IgG分子
Most patients with autoimmune hemolytic anemia (AIHA) have immunoglobulins and / or complement on erythrocytes and can be confirmed by the direct anti-human globulin test (Coombs test). Such immunoglobulins are mostly anti-red blood cell antibodies IgG, a small number of strains of IgG (IgG1 ~ 4), IgM and IgA. According to the antibody combined with complement depletion test, no more than 25 IgG molecules are bound to each erythrocyte under normal conditions. It has been reported that 2 to 4% of patients with autoimmune hemolytic anemia have a direct Coombs test negative. The reasons for the following analysis. 1. Erythrocyte antibody concentration Most of the direct Coombs test negative mostly due to the subject’s red blood cell autoantibody concentration is lower than the test level. A positive IgG molecule appears on each red blood cell