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떆뿕愿踰뺤쓣 씠슜븳 ABO삁븸삎 寃궗뿉꽌 삁援 쓳吏묒젙룄뿉 쁺뼢쓣 誘몄튂뒗 슂씤遺꾩꽍
Factors Affecting Hemagglutinations Strength in ABO Blood Group Typing Test Using the Tube Method
J Lab Med Qual Assur 2018;40:161-170
Published online September 30, 2018
© 2018 Korean Association of External Quality Assessment Service.

쟾쑀씪1, 씠슦씤1,2, 媛뺤냼쁺1,2, 源紐낇씗1,2
You La Jeon1, Woo-In Lee1,2, So Young Kang1,2, Myeong Hee Kim1,2

1媛뺣룞寃쏀씗븰援먮퀝썝 吏꾨떒寃궗쓽븰怨,
2寃쏀씗븰援 쓽怨쇰븰 吏꾨떒寃궗쓽븰援먯떎

1Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, Korea
2Department of Laboratory Medicine, Kyung Hee University School of Medicine, Seoul, Korea
Correspondence to: Woo-In Lee Department of Laboratory Medicine, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea Tel: +82-2-440-7190 Fax: +82-2-440-7195 E-mail: wileemd@khu.ac.kr
援먯떊옄: 씠슦씤 슦)05278 꽌슱떆 媛뺣룞援 룞궓濡 892, 媛뺣룞寃쏀씗븰援먮퀝썝 吏꾨떒寃궗쓽븰怨 Tel: 02)440-7190, Fax: 02)440-7195, E-mail: wileemd@khu.ac.kr
Received June 28, 2018; Revised August 15, 2018; Accepted August 20, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract

諛곌꼍:

ABO삁븸삎 寃궗뒗 삁援ъ쓳吏묒쓣 湲곕낯쑝濡 븯硫, 媛옣 癒쇱 떆뻾릺뒗 닔삁 쟾 寃궗씠떎. 삁援ъ쓳吏묒뿉 쁺뼢쓣 誘몄튂뒗 蹂닔뒗 떎뼇븯吏留 엫긽寃궗떎뿉꽌 뼱뼸寃 쟻슜븯怨 엳怨, 떎젣 쓳吏묒뿉 뼱뼡 쁺뼢쓣 誘몄튂뒗 吏뿉 븳 뿰援щ뒗 遺議깊븳 긽솴씠떎. 蹂 뿰援щ뒗 떎닔쓽 湲곌씠 궗슜븯怨 엳뒗 떆뿕愿踰뺤쓣 씠슜븳 ABO삁븸삎 寃궗怨쇱젙 以묒뿉꽌 삁援 쓳吏묎컯룄뿉 쁺뼢쓣 誘몄튂뒗 씤옄瑜 遺꾩꽍븯떎.

諛⑸쾿:

51媛 湲곌뿉 빐 삁援ы삎, 삁泥삎 寃궗怨쇱젙뿉 븳 옄꽭븳 꽕臾몄“궗瑜 떆뻾븯떎. 媛 寃궗怨쇱젙 以 삁援 쓳吏묎컯룄뿉 쁺뼢쓣 誘몄튌 닔 엳怨 湲곌留덈떎 긽씠븯寃 쟻슜븯怨 엳뒗 紐 媛쒖쓽 蹂닔瑜 吏젙븯뿬 삁援ы삎 寃궗 10媛吏, 삁泥삎 寃궗 11媛吏쓽 議곌굔쓣 留뚮뱾뿀떎. 삁援ы삎 寃궗 40媛, 삁泥삎 寃궗 40媛 寃泥대 媛곴컖쓽 議곌굔뿉 뵲씪 떎뿕븳 썑 쓳吏묎컯룄瑜 鍮꾧탳, 遺꾩꽍븯떎.

寃곌낵:

꽕臾멸껐怨, 寃泥대줈 궗슜븯뒗 삁援щ쑀븸 젣議곕갑踰, 궗슜릺뒗 떆뿕愿 洹쒓꺽怨 옱猷, 썝떖諛⑸쾿, 삁援ъ떆빟 젣議곕갑踰, 寃궗 떆 寃泥댁 빆삁泥떆빟 삉뒗 삁援ъ떆빟怨 삁泥 鍮꾩쑉, 썝떖 썑 뙋룆 쟾뿉 떆뿕愿쓣 쓷뱶뒗 諛⑸쾿 벑씠 湲곌留덈떎 留ㅼ슦 떎뼇븯떎. 씠瑜 떎뿕뿉 諛섏쁺븯뿬 삁援ы삎 寃궗 삁泥삎 寃궗 썑 쓳吏묎껐怨쇰 遺꾩꽍븳 寃곌낵, 삁援ы삎 寃궗뿉꽌뒗 寃泥댁씤 삁援ъ븸쓣 삁援ъ링뿉꽌 吏곸젒 梨꾩랬븯뿬 諛붾줈 궗슜븳 寃쎌슦뿉 떎닔쓽 寃泥댁뿉꽌 쓳吏묎컯룄媛 빟븯寃 굹궗떎. 삁泥삎 寃궗뿉꽌뒗 떆뿕愿 쓷뱶뒗 諛⑸쾿씠굹 옄媛젣議고븳 삁援ъ떆빟쓽 냽룄瑜 鍮꾨’빐 떎뼇븳 슂씤뱾씠 쓳吏묎컯룄뿉 쁺뼢쓣 誘몄낀떎.

寃곕줎:

젙솗븳 삁븸삎 寃궗瑜 쐞빐 蹂 뿰援ъ뿉꽌 諛앺吏 떆뿕愿踰 떆뻾 떆 삁援 쓳吏묎컯룄뿉 쁺뼢쓣 誘몄튂뒗 씤옄瑜 룷븿븯뿬 옄꽭븳 寃궗怨쇱젙 吏移⑥쓽 젙由쎌씠 븘슂븯떎.

Background:

The ABO blood group typing test (ABO test) is an initial pre-transfusion test based on hemagglutination. Although various factors affect hemagglutination strength, few studies have examined how these factors can be applied in clinical laboratories and their effects on hemagglutination. This study was conducted to analyze the factors affecting hemagglutination strength in the ABO test using a tube method applied in many laboratories.

Methods:

We conducted a detailed questionnaire survey of 51 laboratories which use the ABO test with a tube method. We also analyzed the results of the ABO test (cell and serum typing) with 40 specimens using factors affecting hemagglutination at a tube method and applied differently in each laboratory.

Results:

Each laboratory used various methods to prepare red cell suspensions as specimens or reagents and used different reagent to sample ratios, centrifugation protocols, and shaking test tubes before evaluating hemagglutination strength. By testing various combinations of these factors, direct sampling from the red cell layer of the original specimen was found to have the largest effect on lowering hemagglutination strength in cell typing tests. In serum typing tests, various factors influenced hemagglutination strength, including shaking the tube before analysis and the concentration of a home-made red cell suspension used as a reagent.

Conclusions:

To achieve accurate results in the ABO test by the tube method, detailed guidelines that include the factors affecting hemagglutination strength determined in this study should be established.

Keywords : Blood group typing test, Hemagglutination strength, Tube method, Red cell suspension
꽌 濡

ABO 諛 D삁븸삎 寃궗, 鍮꾩삁湲고빆泥 꽑蹂 諛 룞젙寃궗, 援먯감떆뿕 벑怨 媛숈 닔삁 쟾 寃궗뒗 븞쟾븳 닔삁쓣 쐞빐 諛섎뱶떆 젙솗븯寃 씠猷⑥뼱졇빞 븳떎[1]. 洹 以 ABO 諛 D삁븸삎 寃궗뒗 媛옣 癒쇱 떆뻾릺뒗 닔삁 쟾 寃궗濡쒖꽌 솚옄쓽 뿰졊씠굹 吏덊솚, 옄媛 삉뒗 룞醫낇빆泥댁뿉 뵲瑜 쁺뼢씠 엳쓣 닔 엳쑝굹 寃궗瑜 떆뻾븯뒗 湲곌씠굹 寃궗諛⑸쾿뿉 긽愿뾾씠 룞씪븯寃 젙솗븳 寃곌낵媛 蹂닿퀬릺뼱빞 븯뒗 留ㅼ슦 以묒슂븳 寃궗씠떎[2]. 理쒓렐 옄룞솕옣鍮꾩쓽 룄엯씠 솢諛쒗븯吏留, 뒳씪씠뱶굹 떆뿕愿쓣 씠슜븯뒗 닔湲곕쾿씠 떎닔쓽 湲곌뿉꽌 궗슜릺怨 엳怨, 옄룞솕옣鍮꾨 궗슜븯뒗 湲곌뿉꽌룄 닔湲곕쾿쓣 蹂댁“寃궗諛⑸쾿쑝濡 궗슜븯怨 엳쑝硫, 씠 紐⑤뱺 寃궗뒗 삁援ъ쓳吏묒쓣 湲곕낯쑝濡 븯怨 엳떎.

2015뀈룄 삁븸썝 긽 ABO 諛 D삁븸삎 寃궗 쇅遺 닕젴룄議곗궗 궗뾽蹂닿퀬뿉 뵲瑜대㈃ 李몄뿬湲곌쓽 떎닔(63.2%)媛 삁援ы삎怨 삁泥삎 寃궗 紐⑤몢瑜 떆뿕愿踰뺤쑝濡 떆뻾븯怨 엳쑝硫, 27.9%쓽 湲곌 삁援ы삎 뒳씪씠뱶踰뺤쑝濡, 삁泥삎 寃궗뒗 떆뿕愿踰뺤쑝濡 寃궗瑜 븯怨 엳떎[3]. 떆뿕愿踰뺤 뒳씪씠뱶踰뺤뿉 鍮꾪빐 뜑 誘쇨컧븯硫 쟻삁援 쓳吏묎컯룄瑜 젙솗엳 뙋떒븷 닔 엳떎뒗 옣젏씠 엳뼱 닔湲곕쾿쑝濡 留롮씠 궗슜릺怨 엳쓬뿉룄 遺덇뎄븯怨[2], 삁泥삎 寃궗쓽 寃쎌슦 룞씪븳 寃泥댁뿉 빐 1+뿉꽌 4+源뚯 湲곌留덈떎 떎뼇븳 쓳吏묎껐怨쇰 蹂닿퀬븯怨 엳뒗 떎젙씠떎[3]. 洹 썝씤쑝濡 깮媛곹븷 닔 엳뒗 寃껋 쓳吏묎컯룄 뙋룆湲곗씠굹 뙋룆寃쏀뿕쓽 遺議깅퓧 븘땲씪 떆뿕愿踰뺤쓽 寃궗諛⑸쾿 벑씠 엳떎.

떆뿕愿踰뺤쓣 씠슜븳 ABO삁븸삎 寃궗쓽 寃궗怨쇱젙 以 삁援ъ쓳吏묒뿉 쁺뼢쓣 誘몄튌 닔 엳뒗 슂씤쑝濡쒕뒗 떆뿕愿 옱吏덉씠굹 寃泥댁쥌瑜섏 뼇, 썝떖諛⑸쾿 벑씠 엳떎[4-6]. 洹몃윭굹 理쒓렐 寃궗瑜 떆뻾븯뒗 湲곌留덈떎 씠 媛숈 슂씤뱾쓣 뼱뼸寃 쟻슜븯怨 엳뒗吏뿉 븳 떎젣쟻씤 옄猷뚭 뾾怨, 떎뼇븳 슂씤뱾쓽 議고빀쑝濡 닔삁 쟾 寃궗瑜 떆뻾뻽쓣 븣 삁援ъ쓳吏묒뿉 誘몄튂뒗 쁺뼢뿉 빐꽌룄 蹂닿퀬맂 諛붽 뾾떎. 뵲씪꽌 蹂 뿰援ъ뿉꽌뒗 씠뿉 븳 옄猷뚮 議곗궗븯怨, 삁援 쓳吏묎컯룄쓽 뿰愿꽦쓣 遺꾩꽍븯뿬 떆뿕愿踰뺤쓣 씠슜븳 ABO삁븸삎 寃궗瑜 떆뻾븯뒗 湲곌뿉꽌 蹂대떎 넻씪맂 諛⑸쾿쑝濡 寃궗瑜 닔뻾븷 닔 엳룄濡 湲곗큹옄猷뚮 젣怨듯븯怨좎옄 븳떎.

옱猷 諛 諛⑸쾿

蹂 뿰援щ뒗 씪李⑥쟻쑝濡 꽕臾몄쓣 넻븳 議곗궗瑜 떆뻾븯怨, 씠李⑥쟻쑝濡 삁援ы삎 諛 삁泥삎 寃궗諛⑸쾿씠굹 怨쇱젙뿉 븳 꽕臾몄쓽 쓳떟쑀삎 以 鍮덈룄媛 넂 쑀삎쓣 議고빀븯뿬 떎뿕븯떎.

1. 꽕臾몄“궗쓽 긽 諛 궡슜

삁援ы삎 삉뒗 삁泥삎 寃궗뿉 떆뿕愿踰뺤쓣 궗슜븯嫄곕굹 옄룞솕옣鍮꾨 궗슜븯吏留 蹂댁“寃궗濡 떆뿕愿踰뺤쓣 궗슜븯怨 엳뒗 쓽猷뚭린愿 以 52媛 湲곌쓣 긽쑝濡 븯쑝硫, 긽湲곌뿉 씠硫붿씪濡 꽕臾몄쓣 쟾넚븯怨, 떟蹂 떞떦 쟾臾몄쓽 삉뒗 떞떦 蹂묐━궗媛 옉꽦븯룄濡 븯떎. 쉶떊맂 꽕臾 以 遺덊솗떎븳 빆紐⑹ 쟾솕臾몄쓽濡 솗씤븯떎. 꽕臾몄 2017뀈 6썡遺꽣 9썡留먭퉴吏 떆뻾븯쑝硫, 理쒖냼 50媛 湲곌쑝濡쒕꽣 꽕臾몄뿉 븳 쉶떊쓣 諛쏅뒗 寃껋쓣 紐⑺몴濡 븯떎.

꽕臾몄 겕寃 삁븸뻾寃궗떎 쁽솴, 삁援ы삎 寃궗, 삁泥삎 寃궗濡 援ъ꽦븯떎. 삁븸뻾寃궗떎 쁽솴뿉 븳 臾명빆 ABO삁븸삎 寃궗嫄댁닔, 寃궗옄 씤젰援ъ꽦, 궡遺援먯쑁 슏닔, 쓳吏묎컯룄 뙋룆쓣 쐞븳 씠誘몄 遺李 뿬遺, 寃궗떎 궡 삩룄 뒿룄, 썝떖遺꾨━湲 젣議곗궗 紐⑤뜽 벑쑝濡 援ъ꽦븯떎. 삁援ы삎 寃궗 삁泥삎 寃궗臾명빆 媛곴컖 寃泥 슜湲, 寃궗 쟾 寃泥 蹂닿삩룄, 寃궗 떆뻾 쟾源뚯 냼슂떆媛, 떆뿕愿 옱吏, 洹쒓꺽, 寃궗슜 삉뒗 떆빟슜 삁援щ쑀븸 젣議곕갑踰, 떆빟쓽 젣議곗궗 諛 궗슜슜웾, 썝떖諛⑸쾿, 썝떖 썑 떆뿕愿 愿李곕갑踰, 뙋룆諛⑸쾿, 쓳吏묎컯룄 몴湲곕갑踰 벑쓽 吏덈Ц쑝濡 援ъ꽦븯떎.

2. 떎뿕

蹂 뿰援щ 쐞븳 떎뿕 2017뀈 10썡 以묒뿉 떆뻾븯쑝硫, 꽕臾몄“궗 궡슜쓣 諛뷀깢쑝濡 삁援ы삎 諛 삁泥삎 寃궗 媛곴컖뿉 븳 蹂닔瑜 吏젙븯怨, 삁븸삎 寃궗瑜 쐞빐 쓽猶곕맂 寃泥댁쓽 옍뿬寃泥대 궗슜븯쑝硫, 옍뿬寃泥닿 諛쒖깮븷 븣留덈떎 떎뿕븯떎. 삁援ы삎 寃궗뒗 6媛 蹂닔쓽 꽭遺궗빆쓣 議고빀븯뿬 10媛吏 떎뿕議곌굔쓣 議곗꽦븯쑝硫, 媛곴컖 議곌굔留덈떎 40媛쒖쓽 룞씪븳 寃泥대줈 珥 400쉶쓽 떎뿕쓣 떆뻾븯떎. 삁泥삎 寃궗뒗 7媛 蹂닔쓽 蹂닔쓽 꽭遺궗빆쓣 議고빀븯뿬 11媛吏 떎뿕議곌굔쓣 議곗꽦븯怨, 媛곴컖쓽 議곌굔뿉 뵲씪 30媛쒖쓽 룞씪븳 썝寃泥댁 10媛쒖쓽 2諛 씗꽍븳 寃泥대줈 珥 440쉶쓽 떎뿕쓣 떆뻾븯떎. 삁援ы삎 떎뿕뿉꽌뒗 A, B빆썝씠 諛쒗쁽릺뼱 엳吏 븡 O삎 寃泥대, 삁泥삎 떎뿕뿉꽌뒗 빆-A, B 빆泥닿 뾾뒗 AB삎 寃泥대 諛곗젣븯怨 떎뼇븳 삁븸삎씠 援ъ꽦릺룄濡 븯떎.

삁援ы삎 寃궗쓽 6媛 蹂닔뒗 떆뿕愿쓽 옱吏(쑀由/뵆씪뒪떛), 삁援ъ븸 梨꾩랬諛⑸쾿(떇뿼닔 꽭泥 썑 떇뿼닔 샎빀븯뿬 2%-5% 삁援щ쑀븸; 삁援ъ링怨 삁泥쓣 샎빀븯뿬 梨꾩랬; 삁援ъ링뿉꽌 吏곸젒 梨꾩랬), 떆빟(Sihdia [Shingyang Diagnostics, Siheung, Korea]; Novaclone [Dominion Biologicals, Dartmouth, Canada]), 삁援ъ븸 떆빟쓽 鍮(1:1/1:2), 썝떖遺꾨━諛⑸쾿(3,000 rpm, 15 seconds; 2,000 rpm, 15 seconds), 썝떖 썑 떒닚 移⑥쟾怨 援щ텇븯湲 쐞빐 떆뿕愿쓣 쓷뱶뒗 諛⑸쾿(竊30째 1-4쉶; 竊30째 5-10쉶; <30째 1-4쉶; <30째 5-10쉶)씠硫, 媛곴컖쓽 蹂닔瑜 議고빀븳 궡슜 Table 1뿉 젣떆븯떎. 꽕臾몄“궗뿉꽌 媛옣 留롮씠 궗슜맂 빆삁泥떆빟 Bioscot (Millipore, Livingston, UK) 젣뭹씠吏留 2017뀈 以묐컲 씠썑 닔엯씠 以묐떒맂 긽깭濡 떎뿕뿉 룷븿떆궗 닔 뾾뿀떎.

Table 1 . Combination of various factors affecting hemagglutination in cell typing (40 specimens).

No.긖ube긓ed cell suspension as specimen귺ntisera reagentRatio of specimens and reagentCentrifugation (rpm, sec)Shaking tube before interpretation (angle, times)
1*Glass2%5% with salineSIHDIA1:13,000, 15>30째, 510
2Glass2%5% with salineSIHDIA1:13,000, 15>30째, 14
3<30째, 14
4<30째, 510
52,000, 15>30째, 510
61:23,000, 15
7NOVA1:1
8Mixed with serum and red cell layerSIHDIA
9Direct sampling from the red cell layer
10Plastic2%5% with saline

*This is the method performed by our laboratory.


삁泥삎 寃궗쓽 6媛 蹂닔뒗 寃泥댁쓽 醫낅쪟(삁泥/삁옣), 떆뿕愿쓽 옱吏(쑀由/뵆씪뒪떛), 옄媛젣議 삁援ъ떆빟쓽 냽룄 궗슜湲곌컙(젣議 떦씪 3.85%; 젣議 썑 7씪吏 3.85%; 젣議 떦씪 2%; 젣議 떦씪 5%), 삁援ъ떆빟 寃泥 鍮꾩쑉(1:1/1:2), 썝떖遺꾨━諛⑸쾿(3,000 rpm, 15 seconds; 2,000 rpm, 15 seconds), 썝떖 썑 떒닚 移⑥쟾怨 援щ텇븯湲 쐞빐 떆뿕愿쓣 쓷뱶뒗 諛⑸쾿(<30째 1-4쉶; <30째 5-10쉶; 竊30째 1-4쉶; 竊30째 5-10쉶)씠硫, 媛곴컖쓽 蹂닔瑜 議고빀븳 궡슜 Table 2뿉 젣떆븯떎. 삁泥삎 떎뿕뿉꽌 珥 40媛쒖쓽 寃泥 以 10寃泥대뒗 빆泥 뿭媛媛 궙쓣 寃쎌슦瑜 蹂닿린 쐞빐 삁泥쓣 2諛 씗꽍븯뿬 떎뿕븯떎.

Table 2 . Combination of various factors affecting hemagglutination in serum typing (40 specimens; 30 original specimens and 10 diluted specimens).

No.긖ubeRed cell suspension as reagent (%)Days*Specimen (serum or plasma)Ratio of reagent and specimenCentrifugation (rpm, sec)Shaking tube before interpretation (angle, times)
1Glass3.850Serum1:23,000, 15<30째, 14
2Glass3.850Serum1:23,000, 15<30째, 510
3>30째, 14
4>30째, 510
52,000, 15<30째, 14
61:13,000, 15
7Plasma1:2
87Serum
920
105
11Plastic3.85

*Days elapsed from the day of preparation of rec cell suspension.

This is the method performed by our laboratory.


媛 議고빀濡 떆뻾븳 떎뿕쓽 寃곌낵뒗 媛뺣룞寃쏀씗븰援먮퀝썝뿉꽌 떆뻾 以묒씤 諛⑸쾿(삁援ы삎: 쑀由ъ떆뿕愿; 떇뿼닔 꽭泥 썑 떇뿼닔 샎빀븯뿬 2%-5% 냽룄 삁援щ쑀븸; 삁援ъ떆빟 寃泥 鍮꾩쑉 1:1; 썝떖遺꾨━ 3,000 rpm, 15 seconds; 썝떖 썑 竊30째 5-10쉶 쓷뱺 썑 쓳吏묎컯룄 愿李; 삁泥삎: 삁泥/쑀由ъ떆뿕愿/옄媛젣議 삁援ъ떆빟 3.85% 떦씪젣議 썑 궗슜; 삁援ъ떆빟 寃泥 鍮꾩쑉 1:2; 썝떖遺꾨━ 3,000 rpm, 15 seconds; 썝떖 썑 <30째 1-4쉶 쓷뱺 썑 쓳吏묎컯룄 愿李)쓣 湲곗쑝濡 븯뿬 쓳吏묒젙룄(쓬꽦[], trace[짹] 빟 4+)瑜 鍮꾧탳븯떎. 썝떖遺꾨━湲곕뒗 DIACENT-12 (DiaMed, Cressier, Switzerland)瑜 궗슜븯떎.

寃 怨

1. 꽕臾멸껐怨

꽕臾몄쓣 쓽猶고븳 52媛 湲곌씠 紐⑤몢 쓳떟븯怨, 洹 以 異⑹떎븯吏 븡 떟吏瑜 옉꽦븳 1媛 湲곌쓣 젣쇅븯怨 珥 51媛 湲곌쓽 떟吏瑜 넻怨꾨텇꽍뿉 궗슜븯떎.

1) 삁븸뻾寃궗떎쓽 쁽솴

꽕臾몄뿉 李몄뿬븳 51媛 湲곌 39媛쒖쓽 븰蹂묒썝, 12媛쒖쓽 醫낇빀蹂묒썝씠뿀쑝硫, 洹 以 37媛 湲곌 ABO삁븸삎 寃궗嫄댁닔媛 썡 1,000嫄 씠긽씠뿀떎. 遺遺꾩쓽 湲곌뿉꽌 寃궗옄 2씤씠 삁援ы삎, 삁泥삎 寃궗瑜 媛곴컖 떆뻾븯뿬 삁븸삎 寃곌낵瑜 솗씤븯吏留, 5媛(9.8%) 湲곌 寃궗옄 1씤씠 삁援ы삎, 삁泥삎 寃궗瑜 떆뻾븯怨 엳뿀떎. ABO 寃궗닔뻾怨 뙋룆뿉 븳 援먯쑁씠 1뀈뿉 1쉶 誘몃쭔쑝濡 씠猷⑥뼱吏뒗 湲곌(3.9%)룄 씪遺 엳뿀怨, 30%쓽 湲곌뿉꽌뒗 떆뿕愿踰뺤쓽 쓳吏 뙋룆湲곗뿉 븳 씠誘몄瑜 옉뾽옣뿉 遺李⑺븯怨 엳吏 븡떎怨 떟븯떎. 썝떖遺꾨━湲곕뒗 븳씪쓽 SEROSPIN, KUBOTA쓽 KA2200, DIAMED쓽 DIACENT-12瑜 鍮꾩듂븳 遺꾪룷濡 궗슜븯怨 엳뒗 寃껋쑝濡 뙆븙릺뿀떎.

2) 삁援ы삎 寃궗諛⑸쾿 諛 뙋룆

삁援ы삎 寃궗瑜 떆뿕愿踰뺤쑝濡 떆뻾븯嫄곕굹 옄룞솕옣鍮꾩쓽 蹂댁“寃궗濡 궗슜븯怨 엳뒗 42媛 湲곌씠 꽕臾몄뿉 떟븯떎(Table 3). 寃泥 슜湲곕뒗 plain tube瑜 45%쓽 湲곌씠, ethylenediaminetetraacetic acid tube瑜 55%쓽 湲곌씠 궗슜븯怨 엳뿀怨, 寃泥댁쓽 蹂닿 1媛 湲곌쓣 젣쇅븯怨좊뒗 寃궗 쟾源뚯 떎삩뿉 蹂닿븯쑝硫, 빟 70%쓽 湲곌씠 寃泥 룄李 썑 1떆媛 씠궡뿉 寃궗瑜 븯뒗 寃껋쑝濡 뙆븙릺뿀떎. 뵆씪뒪떛怨 쑀由ъ옱吏덉쓽 떆뿕愿쓣 媛곴컖 45%, 52%쓽 湲곌뿉꽌 궗슜븯怨 엳뿀怨, 떆뿕愿 湲몄씠뒗 7.5 cm뿉 吏곴꼍씠 10-12 mm濡 떆뿕愿 洹쒓꺽뿉 엳뼱 겙 李⑥씠뒗 뾾뿀떎. 媛 寃泥댁쓽 삁援ъ븸 梨꾩랬諛⑸쾿씠 떎뼇븯뒗뜲, 꽭泥숆낵젙 뾾씠 깮由ъ떇뿼닔濡 2%-5% 냽룄濡 씗꽍븯뒗 寃쎌슦(38.1%) 썝寃泥댁쓽 삁援ъ링뿉꽌 諛붾줈 梨꾩랬븯뿬 궗슜븯뒗 寃쎌슦(28.6%)媛 鍮꾧탳쟻 留롮븯떎. 삁援ъ븸怨 빆삁泥떆빟쓽 鍮꾩쑉 媛 湲곌뿉꽌 떆뿕愿뿉 꽔뒗 諛⑹슱 닔濡 쓳떟쓣 諛쏆븘 異뷀썑뿉 鍮꾨 怨꾩궛븯쑝硫, 86%쓽 湲곌씠 1:1쓽 鍮꾩쑉쓣 궗슜뻽吏留 씪遺 湲곌 빆삁泥떆빟쓣 2諛곕줈 꽔湲곕룄 븯怨, 븳 湲곌 삁援ъ븸쓣 2諛 꽔뼱 2:1쓽 鍮꾩쑉濡 궗슜븯怨 엳뿀떎. 썝떖 90%쓽 湲곌씠 3,000-3,500 rpm뿉꽌 15-30珥 젙룄 떆媛꾩쑝濡 븯쑝硫, 꽭遺 봽濡쒗넗肄쒖 옣鍮꾨쭏떎 留ㅼ슦 떎뼇븯떎. 떒닚 移⑥쟾怨쇱쓽 援щ퀎쓣 쐞빐 癒쇱 궡吏 湲곗슱뿬 誘몄꽭븳 쓳吏 뿬遺瑜 愿李고븯怨, 30째 誘몃쭔 媛곷룄뿉꽌 빟븯寃 1-4쉶 쓷뱺 썑 愿李고븯뒗 諛⑹떇씠 媛옣 留롮 寃껋쑝濡 굹궗떎. 寃곌낵엯젰 떆뿉뒗 쓳떟湲곌쓽 諛 젙룄(22/42)媛 쓳吏묎컯룄뒗 몴湲고븯吏 븡怨 삁븸삎留 엯젰븳떎怨 븯怨, 쓳吏묎컯룄瑜 몴湲고븯뒗 湲곌 以묒뿉뒗 (쓬꽦[닋], trace[짹] 빟 4+)濡 湲곕줉븯뒗 湲곌씠 75% (15/20)떎.

Table 3 . Results of a survey of cell typing test by the tube method (total=42).

꺿꺿긃actorNo. of laboratories (%)
Blood collection tubes
긑lain tube (plastic)14 (33.3)
긑lain tube (glass)5 (11.9)
긂thylenediaminetetraacetic acid tube23 (54.8)
Material types of tube
긑lastic19 (45.2)
긄lass22 (52.4)
긐ther1 (2.4)
Tube size (diameter, length)
10 mm, 7.5 cm21 (50.0)
12 mm, 7.5 cm15 (35.7)
긐thers6 (14.3)
Red cell suspension as specimen
귾irect sampling from the red cell layer12 (28.5)
긎ixed with serum and red cell layer6 (14.3)
2%5% red cell suspension without saline washing16 (38.1)
2%5% red cell suspension with saline washing7 (16.7)
긐ther1 (2.4)
Ratio of specimen to antisera
1:25 (11.9)
1:136 (85.7)
2:11 (2.4)
Commercial antisera
귻IOSCOT (Millipore)22 (52.4)
긏OVACLONE (Dominion)9 (21.4)
긕IHDIA (Shinyang)8 (19.0)
귻IOCLONE (Ortho)2 (4.8)
긐ther1 (2.4)
Centrifugation (rpm, sec)
1,500, 153 (7.1)
2,000, 301 (2.4)
3,000, 1511 (26.2)
3,0003500, 153027 (64.3)
Shaking tube before interpretation (angle, times)*
<30째, 1422 (52.4)
<30째, 5104 (9.5)
>30째, 141 (2.4)
>30째, 5101 (2.4)
귽ombination11 (26.2)

*Three laboratories answered insufficiently.


3) 삁泥삎 寃궗諛⑸쾿 諛 뙋룆

삁泥삎 寃궗뿉 븳 쓳떟 珥 51媛 湲곌씠 븯쑝硫, 삁옣쓣 궗슜븯뒗 湲곌씠 삁泥쓣 궗슜븯뒗 湲곌蹂대떎 20% 젙룄 뜑 留롮븯떎(Table 4). 寃궗 떆옉 쟾 蹂닿솚寃쎌씠굹 냼슂떆媛, 떆뿕愿 옱吏덉씠굹 洹쒓꺽 벑 븵꽑 삁援ы삎 寃궗쓽 쓳떟怨 嫄곗쓽 쑀궗븯怨, 삁援ъ떆빟怨 寃泥댁쓽 鍮꾩쑉 遺遺꾩쓽 湲곌씠 1:2濡 븯怨 엳뿀쑝硫, 寃泥대 씗꽍븯뿬 궗슜븯뒗 湲곌 뾾뿀떎. 20媛 湲곌 삁援ъ떆빟쓣 吏곸젒 젣議고븯뿬 궗슜븯쑝硫, 31媛 湲곌 떆뙋슜 삁援ъ떆빟쓣 궗슜븯뒗뜲, 洹 以 22媛 湲곌씠 Ortho궗쓽 젣뭹쓣, 굹癒몄 湲곌뿉꽌뒗 誘몃Ⅴ떥씠뀓, DIAGAST, BIORAD 닚쑝濡 궗슜븯怨 엳뿀떎. 썝떖 3,000-3,500 rpm, 15-30珥덈줈 궗슜븯怨, 떆뿕愿 쓷뱶뒗 諛⑹떇룄 삁援ы삎 寃궗 留덉갔媛吏濡 誘몄꽭븳 쓳吏 愿李 썑 30째 誘몃쭔 媛곷룄뿉꽌 빟븯寃 쓷뱺 썑 愿李고븯뒗 諛⑹떇씠 떎닔떎. 嫄곗쓽 紐⑤뱺 湲곌 삁援ы삎 寃궗 鍮꾩듂븯寃 愿李고븯뒗 諛⑹떇쓣 깮븯吏留, 3媛 湲곌뿉꽌뒗 삁泥삎 寃궗蹂대떎 삁援ы삎 寃궗뿉꽌 쓷뱶뒗 媛곷룄瑜 꼻엳嫄곕굹 媛뺣룄瑜 媛뺥븯寃 븯뒗 諛⑹떇쓣 痍⑦븯떎.

Table 4 . Results of a survey of serum typing test by the tube method (total=51).

꺿꺿긃actorNo. of laboratories (%)
Specimen
긑lasma30 (58.9)
긕erum21 (41.1)
Material types of tube
긑lastic22 (43.1)
긄lass28 (54.9)
긐ther1 (2.0)
Tube size (diameter, length)
10 mm, 7.5 cm25 (49.0)
12 mm, 7.5 cm17 (33.3)
긐ther9 (17.7)
Ratio of reagent (red cell suspension) to specimen
1:112 (23.5)
1:234 (66.7)
2:25 (9.8)
Centrifugation (rpm, sec)
1,500, 153 (5.9)
2,500, 301 (2.0)
3,000, 1512 (23.5)
3,0003,500, 153035 (68.6)
Shaking tube before interpretation (angle, times)*
<30째, 1423 (45.1)
<30째, 51010 (19.6)
>30째, 144 (7.8)
>30째, 5102 (3.9)
귽ombination7 (13.7)

*Five laboratories answered insufficiently.


4) 삁援ъ떆빟쓽 젣議곕갑踰

삁援ъ떆빟 젣議곕갑踰뺤뿉 愿븳 꽕臾몄 吏곸젒 젣議고븳 떆빟쑝濡 떎젣 寃궗뿉 궗슜븯뒗 20媛쒖쓽 湲곌怨 蹂댁“슜쑝濡쒕쭔 궗슜븯嫄곕굹 理쒓렐源뚯 젣議고븳 떆빟쓣 궗슜븯뜕 3媛쒖쓽 湲곌, 利 23媛 湲곌씠 떟븯떎(Table 5). 옱猷뚮줈뒗 닔삁슜 냽異뺤쟻삁援ъ쓽 遺꾩젅쓣 궗슜븯뒗 湲곌씠 議곌툑 뜑 留롮븯怨, 遺遺 꽑蹂 떆젏 삉뒗 젣議 썑 빆-A, 빆-B瑜 솗씤븯떎. 삁援 꽑蹂 떆 異붽寃궗濡쒕뒗 쓳떟湲곌쓽 50% 젙룄媛 삁援ъ쓽 Rh 몴쁽삎 寃궗瑜 븯怨 엳뿀怨, 洹 쇅 吏곸젒빆湲濡쒕텋由곌궗, 鍮꾩삁湲고빆泥 꽑蹂꾧궗, 빆-A1 寃궗 벑쓣 떆뻾븯뒗 湲곌룄 긽떦닔 엳뿀떎. 쓳떟븳 湲곌 以 1媛 湲곌 꽑깮吏뿉 엳뒗 紐⑤뱺 寃궗瑜 떆뻾븳떎怨 븯쑝硫, 2媛 湲곌 異붽寃궗瑜 쟾 떆뻾븯吏 븡뒗떎怨 떟븯떎. 23媛 湲곌 以 22媛 湲곌씠 삁援ъ떆빟 젣議 쟾뿉뒗 3쉶 씠긽 꽭泥숈쓣 븯怨, 0.9% 깮由ъ떇뿼닔濡 씗꽍븯뒗 寃껋쑝濡 뙆븙릺뿀떎. 삁援ъ떆빟쓽 냽룄뒗 삁援щ냽異뺤븸怨 씗꽍슜 슜븸쓽 슜웾쓣 吏곸젒 떟븯룄濡 븯怨 異뷀썑 씠瑜 怨꾩궛븯뒗뜲, 19媛(83%)쓽 湲곌씠 2%-5% 냽룄媛 릺룄濡 젣議고븯怨 엳뿀떎. 냽룄媛 2% 誘몃쭔씤 怨녹씠 2媛 湲곌씠뿀怨, 븳 湲곌 냽룄媛 9.1%떎. 삁援ъ떆빟 궗슜씪 80%쓽 湲곌씠 1二쇱씪 씠궡濡 궗슜븯怨 엳떎怨 떟븯怨, 굹癒몄 5媛 湲곌 8씪 씠긽 궗슜븳떎怨 떟븯떎. 젣議고븳 삁援ъ떆빟쓽 蹂닿슜湲곕뒗 쓳떟湲곌쓽 15媛 湲곌씠 씪諛 삁泥遺꾨━愿쓣, 8媛 湲곌씠 쑀由ъ슜湲곗뿉 蹂닿븯怨 뒪룷씠뱶瑜 궗슜븳떎怨 떟븯떎.

Table 5 . Red cell suspension preparation (reagent) (total=23).

꺿꺿긑rocedureNo. of laboratories (%)
Specimen
긕egment of packed RBC14 (60.9)
긂thylenediaminetetraacetic acid blood specimen from healthy individual9 (39.1)
Tests for selection of adequate erythrocytes
귺nti-A and anti-B of prepared red cell suspension13 (56.5)
귺nti-A1 and anti-B of prepared red cell suspension3 (13.0)
귺nti-A and anti-B of selected specimen7 (30.4)
귺nti-A1 and anti-B of selected specimen0
Additional tests for selection of adequate erythrocytes (contained multiple selected responses)
귾irect antiglobulin test (direct Coombs test)9 (39.1)
긗nexpected antibody screening test (37째C)8 (34.8)
긗nexpected antibody screening test (4째C)4 (17.4)
귽heck the response anti-A18 (34.8)
긓h phenotyping test10 (43.5)
긐ther1 (4.3)
긏one2 (8.7)
Step of washing the red cells
12 times1 (4.3)
긎ore than 3 times22 (95.7)
Dilution solution
0.9% NaCl22 (95.7)
긐ther (BIORAD stabilizing solution)1 (4.3)
Concentration of red cell suspension
<1%1 (4.3)
1%2%1 (4.3)
2%3%4 (17.5)
3%5%15 (65.3)
>5% (9.1%)1 (4.3)
귽omparison with commercialized reagent by naked eye1 (4.3)
Validity date
긐nly on day of preparation1 (4.3)
24 days10 (43.5)
57 days7 (30.5)
긐ver 8 days5 (21.7)

2. 떎뿕寃곌낵

Tables 1, 2뿉 젣떆븳 諛붿 媛숈씠 떎뿕븯쑝硫, 寃곌낵뒗 떎쓬怨 媛숈븯떎. 쓳吏묎컯룄媛 湲곗諛⑸쾿쓽 寃곌낵 1 titer 씠긽 李⑥씠瑜 蹂댁씠硫 寃궗諛⑸쾿뿉 뵲瑜 李⑥씠媛 엳뒗 寃껋쑝濡 蹂댁븯떎.

1) 삁援ы삎 寃궗

삁援ы삎 寃궗뿉 궗슜븳 寃泥댁쓽 삁븸삎 遺꾪룷뒗 A삎씠 15媛, Aw삎씠 1媛, B삎씠 20媛, AB삎씠 4媛쒖떎(Table 6). 삁援ы삎 寃궗쓽 쓳吏묎껐怨쇱뿉 媛옣 겙 쁺뼢쓣 誘몄튂뒗 슂씤 삁援ъ븸 梨꾩랬諛⑸쾿씠뿀떎. 삁援ъ븸쓣 삁援ъ링뿉꽌 吏곸젒 梨꾩랬븳 寃쎌슦, 6媛(15%, A삎 3寃泥, B삎 1寃泥, AB삎 2寃泥) 寃泥댁쓽 쓳吏묒씠 湲곗蹂대떎 2 titer 궙寃 愿李곕릺뿀怨, 62.5%씤 25媛쒖쓽 寃泥댁뿉꽌 1 titer 궙寃 愿李곕릺뿀떎. 삉븳 媛곷룄뿉 긽愿뾾씠 1-4쉶 쓷뱺 썑 愿李고븳 寃쎌슦 Aw삎 寃泥댁뿉꽌 2 titer 넂寃 愿李곕릺뿀떎. 洹몃컰뿉 떆뿕愿 옱吏, 빆삁泥떆빟쓽 醫낅쪟, 삁援ъ븸怨 떆빟쓽 鍮꾩쑉 벑 쓳吏묎껐怨쇱뿉 쁺뼢쓣 二쇱 븡븯떎.

Table 6 . Effects of various factors on hemagglutination.

꺿꺿긃actorsNo. of specimens representing differences (%)Differences in hemagglutination strength
Cell typing on 40 specimens (blood group: A=15, Aw=1, B=20, AB=4)
긓ed cell suspension
꺿귾irect sampling from the red cell layer32 (80.0)
25 (62.5)
6 (15.0)뼹뼹
1* (2.5)
꺿긎ixed with serum and red cell layer11 (27.5)
긕haking
꺿<30째, 141* (2.5)뼰뼰
꺿>30째, 141* (2.5)뼰뼰
꺿귽entrifugation (2,000 rpm, 15 sec)1* (2.5)
Serum typing on 30 specimens (blood group: A=6, B=14, O=10)
긓atio of reagent (red cell suspension) to specimen 1:17 (23.3)
긓ed cell suspension
꺿2%5 (16.7)
4 (13.3)
1 (3.3)뼹뼹
꺿5%4 (13.3)
3.85% (7 days after preparation)6 (20.0)
긕haking
꺿<30째, 5104 (13.3)
2 (6.7)
2 (6.7)뼹뼹
꺿>30째, 142 (6.7)
꺿>30째, 51017 (56.7)
12 (40.0)
5 (16.7)뼹뼹
긎aterial types of tube (plastic)3 (10.0)
2 (6.7)
1 (3.3)뼹뼹
긕pecimen (plasma)1 (3.3)
귽entrifugation (2,000 rpm, 15 sec)4 (13.3)

*Weak subtype of blood group A.


2) 삁泥삎 寃궗(씗꽍 寃泥 젣쇅)

삁泥삎 寃궗쓽 쓳吏묎껐怨쇱뿉 誘몄튂뒗 쁺뼢씤옄뒗 삁援ы삎 寃궗뿉 鍮꾪빐 떎뼇븯떎. 삁援ъ떆빟 鍮 삁泥쓽 鍮꾩쑉쓣 1:1濡 븳 寃쎌슦 23.3%쓽 寃泥댁뿉꽌 1:2 鍮꾩쑉濡 寃궗븳 寃껋뿉 鍮꾪빐 1 titer 궙 寃곌낵瑜 蹂댁떎(Table 6). 젣議고븳 삁援ъ떆빟쓽 냽룄媛 2% 삉뒗 5%씪 븣, 삉뒗 湲곗怨 媛숈 3.85%씠굹 젣議곗씪씠 7씪쓣 寃쎄낵븯쓣 븣 쓳吏묎컯룄媛 1-2 titer 궙븘吏뒗 寃껋쓣 븣 닔 엳뿀떎. 媛옣 留롮 쁺뼢쓣 誘몄튇 씤옄뒗 쓳吏 뙋룆 쟾뿉 떆뿕愿쓣 쓷뱶뒗 슏닔뒗뜲, 媛곷룄뿉 긽愿뾾씠 5-10쉶 쓷뱾뿀쓣 븣 珥 21媛(70.0%) 寃泥댁쓽 寃곌낵媛 湲곗뿉 鍮꾪빐 1-2 titer 궙寃 뙋룆릺뿀떎. 洹 諛뽰뿉 썝떖쓣 2,000 rpm뿉 15珥덈줈 쟻슜븳 寃쎌슦(13.3%)뿉꽌 씪遺 寃泥대뱾씠 1 titer 궙 寃곌낵瑜 蹂댁떎.

3) 삁泥삎 寃궗(씗꽍 寃泥)

삁泥삎 寃궗뿉꽌 빆泥 뿭媛媛 궙 寃쎌슦뿉 뼱뼡 쁺뼢씠 엳뒗吏 議곗궗븯湲 쐞빐 10媛 寃泥대 씗꽍븯뿬 떎뿕븯떎(Table 7). 씗꽍 寃泥대 씠슜븳 寃궗뿉꽌룄 삁援ъ떆빟쓽 냽룄媛 꼫臾 궙嫄곕굹 넂 寃쎌슦 삉뒗 옄媛 젣議 썑 7씪 씠긽 寃쎄낵븳 寃쎌슦 벑씠 寃泥 쓳吏묎껐怨쇱뿉 쁺뼢쓣 誘몄낀떎. 삉븳 뙋룆 쟾 쓷뱶뒗 슏닔뿉 뵲瑜 쁺뼢쓣 媛옣 留롮씠 諛쏆븯怨, 媛곷룄뿉 긽愿뾾씠 5-10쉶 쓷뱺 寃쎌슦 10媛 以 6媛(60%) 寃泥댁뿉꽌 쓳吏묎컯룄媛 1-2 titer 궙寃 뙋룆릺뿀怨, 쓷뱶뒗 슏닔瑜 1-4쉶濡 湲곗怨 룞씪븯寃 븯吏留 30째 씠긽 媛곷룄瑜 쟻슜븳 寃쎌슦뒗 30%쓽 寃泥댁뿉꽌 1 titer 궙 쓳吏묒쓣 蹂댁떎. 썝떖 봽濡쒗넗肄쒖쓣 2,000 rpm뿉 15珥덈줈 쟻슜뻽쓣 븣 30%쓽 寃泥닿 湲곗蹂대떎 1-2 titer 궙 寃곌낵瑜 蹂댁떎.

Table 7 . Effects of various factors on hemagglutination in diluted serum (10 specimens).

꺿꺿긃actorsNo. of specimens representing differences (%)Differences in hemagglutination strength
Ratio of reagent (red cell suspension) to specimen 1:13 (30.0)
2 (20.0)
1 (10.0)뼹뼹
Red cell suspension
2%4 (40.0)
2 (20.0)
2 (20.0)뼹뼹
5%6 (60.0)
5 (50.0)
1 (10.0)뼹뼹
3.85% (7 days after preparation)5 (50.0)
4 (40.0)
1 (10.0)뼹뼹
Shaking
<30째, 5106 (60.0)
>30째, 143 (30.0)
>30째, 5106 (60.0)
4 (40.0)
2 (20.0)뼹뼹
Material types of tube (plastic)2 (20.0)
Specimen (plasma)1 (10.0)
Centrifugation (2,000 rpm, 15 sec)3 (30.0)
2 (20.0)
1 (10.0)뼹뼹

怨 李

삁븸삎 寃궗뿉꽌 떆뿕愿踰뺤 2015뀈 쇅遺 닕젴룄議곗궗뿉 李몄뿬븳 遺遺꾩쓽 湲곌씠 떆뻾븯怨 엳뒗 寃궗踰뺤씠떎[3]. 蹂 뿰援ъ뿉꽌뒗 닔삁쓽븰 援먭낵꽌뿉 젣떆맂 삁援ы삎 諛 삁泥삎 寃궗쓽 떆뿕愿踰뺢궗뿉꽌 삁援ъ븸 냽룄굹 삁援ъ븸怨 빆삁泥 삉뒗 삁援ъ떆빟怨 삁泥쓽 鍮꾩쑉, 썝떖 봽濡쒗넗肄쒖쓣 룷븿븯뿬 옄꽭븳 怨쇱젙뿉 븳 꽕臾몄쓣 븯떎. 洹 寃곌낵, 寃궗뿉 궗슜븯뒗 떆뿕愿 옱猷뚮굹 寃泥, 寃궗諛⑸쾿, 뙋룆諛⑸쾿씠 넻씪릺뼱 엳吏 븡븯怨, 援먭낵꽌뿉 젣떆맂 寃껉낵 떎瑜 諛⑸쾿쑝濡 寃궗븯뒗 湲곌룄 엳뿀떎.

삁瑜 뱾硫 삁援ы삎 寃궗뿉꽌 삁援 寃泥대뒗 2%-5% 냽룄쓽 삁援щ쑀븸쓣 留뚮뱾뼱 寃궗븯룄濡 븞궡븯怨 엳쑝굹 꽕臾몄뿉 쓳븳 씪遺 湲곌뱾 썝寃泥댁쓽 삁援ъ링뿉꽌 諛붾줈 梨꾩랬븯뿬 궗슜븯떎[7]. 씠 諛⑸쾿 뒳씪씠뱶踰뺤뿉꽌 궗슜뻽뜕 諛⑸쾿쑝濡, 뒳씪씠뱶踰뺤뿉꽌 떆뿕愿踰뺤쑝濡 쟾솚븯硫댁꽌 삁援ъ븸 梨꾩랬諛⑸쾿쓣 蹂寃쏀븯吏 븡븯쓣 媛뒫꽦씠 엳떎. 떎뿕뿉꽌룄 솗씤븯吏留, 썝寃泥 삁援ъ븸 怨쇰웾쓽 삁援ш 룷븿릺뼱 엳쑝誘濡 빆삁泥쓽 빆泥댁뿉 鍮꾪빐 쟻삁援 빆썝쓽 鍮꾩쑉씠 넂븘졇 理쒖쟻쓽 쓳吏묒쓣 諛⑺빐븯怨[1], 븘삎뿉꽌뒗 빆썝웾씠 쟻뼱 빟븯寃 굹굹빞 븯뒗 쓳吏묒쓣 媛뺥븯寃 븯뿬 뙋룆뿉 삤瑜섎 媛졇삱 닔 엳떎. 洹몃윭誘濡 삁援ы삎 寃궗 떆뿉 삁援ъ븸쓣 썝寃泥댁뿉꽌 吏곸젒 梨꾩랬븯뒗 諛⑸쾿 젙솗븳 뙋룆쓣 쐞빐 吏뼇빐빞 븳떎.

삉븳 썝떖 봽濡쒗넗肄쒖쓽 寃쎌슦 3,400 rpm뿉 15珥덈 븞궡븯怨 엳吏留, 湲곌留덈떎 궗슜븯뒗 봽濡쒗넗肄쒖씠 떎뼇븯떎. 媛숈 rpm쓣 쟻슜빐룄 옣鍮꾩뿉 뵲씪 g 媛믪씠 떖씪吏 닔 엳뼱 젙솗븳 遺꾩꽍 뼱졄吏留, 蹂 뿰援ъ뿉꽌 룞씪 옣鍮꾨줈 3,000 rpm怨 2,000 rpm뿉 媛곴컖 15珥덇컙 썝떖븳 寃곌낵 2,000 rpm쑝濡 썝떖쓣 뻽쓣 븣 븘삎 寃泥댁뿉꽌 쓳吏묎컯룄媛 빟븯寃 굹궗떎. 썝떖 봽濡쒗넗肄쒖뿉 뵲瑜 쁺뼢 삁泥삎 寃궗뿉꽌룄 씪遺 굹궗怨, 씗꽍 삁泥쓣 궗슜븳 삁泥삎 寃궗뿉꽌뒗 30%뿉 빐떦븯뒗 寃泥닿 1-2 titer 궙 쓳吏묎컯룄瑜 蹂댁떎. 썝떖怨쇱젙 쟻삁援 몴硫댁쓽 쓬꽦 쟾븯 븣臾몄뿉 꽌濡 諛뼱궡뒗 寃껋쓣 씠寃⑤궡怨 immunoglobulin-G뿉 쓽븳 쓳吏묒쓣 媛뒫븯寃 븯뿬 삁援 쓳吏묎컯룄뿉 吏곸젒쟻씤 쁺뼢쓣 誘몄튇떎[1]. 洹몃윭誘濡 삁援 쓳吏묎컯룄媛 湲곌뿉 鍮꾪빐 궙 寃쏀뼢쓣 蹂댁씤떎硫 썝떖 봽濡쒗넗肄쒕룄 젏寃빐 蹂 븘슂媛 엳怨, 빆泥 뿭媛媛 궙 寃泥대씪硫 뜑슧 쁺뼢쓣 諛쏆쑝誘濡 쟻슜븯怨 엳뒗 봽濡쒗넗肄쒖씠 쟻젙븳吏 솗씤빐빞 븳떎.

洹몃컰뿉 삁泥삎 寃궗寃곌낵뿉 쁺뼢쓣 誘몄튂뒗 슂씤 삁援ы삎 寃궗뿉 鍮꾪빐 뜑슧 떎뼇븳 寃껋쑝濡 遺꾩꽍릺뿀떎. 삁援ъ떆빟 鍮 삁泥쓽 鍮꾩쑉씠 궙嫄곕굹, 옄媛젣議고븳 삁援ъ떆빟쓽 냽룄媛 궙嫄곕굹 넂 寃쎌슦, 삉뒗 7씪 씠긽 寃쎄낵맂 寃쎌슦뿉 삁援ъ쓳吏묒쓽 媛뺣룄媛 궙븘吏怨, 듅엳 씗꽍븳 寃泥댁뿉꽌뒗 洹 쁺뼢씠 뜑슧 슌졆븯떎. 듅엳 怨좊졊씠굹 硫댁뿭寃고븤꽦 吏덊솚 삉뒗 硫댁뿭寃고븤긽깭濡 빆泥 뿭媛媛 궙 寃쎌슦뿉 뙋룆뿉 삤瑜섍 깮湲 닔 엳쑝誘濡 삁븸뻾寃궗떎留덈떎 씠뿉 븳 젏寃씠 븘슂븯떎[8-11]. 洹몃윭誘濡 젣議고븯뒗 삁援ъ떆빟쓽 냽룄瑜 3%뿉 媛源앷쾶 留욎텛怨, 삁援ъ떆빟怨 삁泥쓽 鍮꾩쑉 1:2濡 빐빞 쟻젅븳 삁援ъ쓳吏묒쓣 쑀룄븷 닔 엳쓣 寃껋쑝濡 깮媛곷맂떎.

궗슜씪뿉 빐꽌뒗 蹂 뿰援ъ뿉꽌뒗 理쒖냼븳 7씪 씠긽 궗슜븯硫 쓳吏묎컯룄媛 궙븘吏 닔 엳쓬쓣 솗씤븯뒗뜲, 삁援ъ떆빟 젣議 썑 떆씪뿉 뵲瑜 ABO빆泥 뿭媛瑜 鍮꾧탳븳 뿰援ъ뿉꽌 떆뿕愿踰뺤쓽 寃쎌슦 6씪吏몃꽣, 寃붿뭅뱶踰뺤쓽 寃쎌슦 5씪吏몃꽣 뿭媛媛 쑀쓽븯寃 궙븘吏뒗 寃껋쑝濡 蹂닿퀬븯떎[12]. 삉븳 AABB뿉꽌뒗 꽦뒫뿉 븳 쟻젅븳 寃利앹쓣 븯吏 븡뒗떎硫 떦씪 젣議고븳 寃껋쓣 궗슜븯룄濡 븞궡븯怨 엳뼱, 2씪 씠긽 궗슜븷 寃쎌슦 씪諛 떆빟怨 留덉갔媛吏濡 궗슜 쟾뿉 젙룄愿由щ 븯뿬 洹 諛섏쓳씠 젣議 떦씪怨 룞씪븳 吏 솗씤븳 썑 궗슜빐빞 븷 寃껋씠떎[1].

븳렪, 삁援ъ떆빟쓽 옄媛젣議 떆뿉 떆빟쑝濡쒖꽌쓽 쟻젙꽦 솗씤쓣 쐞븳 寃궗뿉 븳 꽕臾몄“궗寃곌낵뒗 湲곌留덈떎 留ㅼ슦 긽씠븯뿬 異붽寃궗瑜 쟾 떎떆븯吏 븡뒗 湲곌룄 엳뿀怨, 蹂닿린뿉 젣떆븳 紐⑤뱺 寃궗瑜 떆뻾븯뒗 湲곌룄 엳뿀떎. 씠뿉 븳 沅뚭퀬궗빆룄 븘吏곴퉴吏 젙由쎈릺뼱 엳吏 븡떎. 떎留, 삁援щ 꽑깮븷 븣 삁븸삎씠 媛숈 뿬윭 삁븸뿉꽌 梨꾩랬븯뿬 꽎뒗떎硫 Rh빆썝쓣 鍮꾨’븳 쟻삁援 빆썝삎씠 떎뼇빐吏怨 빆썝뼇 긽쟻쑝濡 궙븘졇 ABO瑜 젣쇅븳 떎瑜 빆썝-빆泥대컲쓳뿉 쓽븳 媛꾩꽠씠 以꾩뼱뱾 닔 엳떎[12]. 삉븳 援궡 ABO삁븸삎 寃궗슜 떆빟쓽 뿀媛 諛 떖궗 媛씠뱶씪씤뿉꽌 떆뙋슜 삁援ъ떆빟쓽 떆뿕洹쒓꺽뿉 吏곸젒빆湲濡쒕텋由곌궗뿉 쓬꽦씪 寃껋쓣 슂援ы븯怨 엳쑝誘濡 옄媛젣議 떆빟뿉꽌룄 씠뿉 븳 솗씤 븘슂븷 寃껋쑝濡 깮媛곷맂떎[13].

蹂 뿰援щ뒗 꽕臾몃텇꽍 긽湲곌씠 51媛 湲곌쑝濡 꽕臾몄씠 븳젙쟻쑝濡 씠猷⑥뼱議뚮떎뒗 寃껉낵, 빆썝씠 빟븳 븘삎 삁븸쓽 寃異쒖뿉 엳뼱 삁援 쓳吏묎컯룄뿉 誘몄튂뒗 쁺뼢씤옄遺꾩꽍씠 以묒슂븿뿉룄 븘삎 삁븸삎 寃泥닿 냼닔留 룷븿릺뿀떎뒗 젣븳젏씠 엳떎.

蹂 뿰援щ 넻빐 떆뿕愿쓣 씠슜븳 ABO삁븸삎 寃궗뿉꽌 젙솗븳 삁援ъ쓳吏묎껐怨쇰 뼸湲 쐞빐꽌뒗 寃泥댁슜 삁援щ쑀븸씠굹 젣議고븯뒗 삁援ъ떆빟쓽 寃쎌슦 2%-5% 씠궡쓽 냽룄濡 젣議고븯怨, 삁援ъ떆빟쓽 寃쎌슦 젣議 떦씪씠 븘땶 寃쎌슦 쓳吏묎컯룄 솗씤 썑 궗슜븯릺 理쒖냼븳 7씪쓣 꽆湲곗 븡룄濡 븯硫, 젣議 떆 뿬윭 삁븸쓣 꽎뼱 궗슜븯怨 理쒖냼븳 吏곸젒빆湲濡쒕텋由곌궗 寃곌낵媛 쓬꽦엫쓣 솗씤빐빞 븿쓣 븣 닔 엳떎. 쟻젙 썝떖 봽濡쒗넗肄쒖쓣 쟻슜븯怨 엳뒗吏 젏寃븯怨 썝떖 썑 쟻떦븳 媛곷룄 媛뺣룄濡 떆뿕愿쓣 쓷뱾뼱 솗씤븯뒗 怨쇱젙룄 븘슂븯떎.

삉븳 떎닔쓽 湲곌씠 궗슜븯怨 엳뒗 삁븸삎 寃궗踰뺤씤 떆뿕愿踰뺤쓽 寃궗怨쇱젙뿉 븳 옄꽭븳 吏移⑥쓽 젙由쎌씠 븘슂븿쓣 븣 닔 엳뿀쑝硫, 쁽옱 삁븸븞쟾궗뾽떒뿉꽌 떆뻾븯怨 엳뒗 쓳吏묎컯룄 遺꾩꽍봽濡쒓렇옩쓣 넻빐 湲곌留덈떎 룞씪븳 寃곌낵瑜 룄異쒗븷 닔 엳룄濡 븯뒗 끂젰씠 슂援щ맂떎.

媛먯궗쓽 湲

씠 끉臾몄 븳엫긽寃궗젙룄愿由ы삊쉶 2017뀈 븰닠뿰援щ퉬 吏썝뿉 쓽빐 씠猷⑥뼱議뚮떎(2017-08).

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