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目的调查Rh血型系统同种抗体在单一医院备血患者人群中的分布情况,分析Rh血型同种抗体产生原因及临床意义。方法对备血患者进行不规则抗体筛查及抗体鉴定,对鉴定为Rh血型抗体者,检测其红细胞表面相应Rh抗原并统计患者相关资料。结果在146 896例备血患者中,1 200(0.82%)例抗体筛选阳性,其中534例患者检测出Rh血型系统同种抗体,抗体特异性为抗-E 300例(56.18%),抗-cE 72例(13.48%),抗-D 66例(12.36%),抗-Ce 64例(11.99%),抗-c 16(3.00%),抗-C 8例(0.75%),抗-e 3例(0.56%),抗-D+G、抗-D+G+C与抗-G+C各2例(0.37%),抗-G、抗-D+E与抗-Cw各1例(0.19%);抗-E、抗-D、抗-G和抗-cE患者检出率在输血史与妊娠史各自互相进行比较P<0.05;Rh血型系统同种抗体总体检出率在性别方面,2者不具有统计学意义(P>0.05),抗-D和抗-Ce在女性患者中总体检出率明显大于男性(P<0.05),抗-cE在男性患者中检出率大于女性(P<0.05)。结论 Rh血型系统同种抗体的检出率低于白种人,其中抗-E检出率最高;妊娠和输血是Rh血型系统同种抗体产生的主要免疫因素,对拟输血患者,推荐Rh抗原同型输血,对从源头上减少Rh血型系统同种抗体引起的输血反应具有重要意义。
Objective To investigate the distribution of alloantibodies of Rh blood group in the population of patients with blood preparation in a single hospital and analyze the causes and clinical significance of Rh alloantibodies. Methods Blood samples were collected for irregular antibody screening and antibody identification. For those patients who were identified as Rh blood group antibodies, the corresponding Rh antigens were detected on the surface of erythrocytes and statistical data were collected. Results Among 146 896 patients with blood preparation, 1 200 (0.82%) were screened positive, of which 534 patients were detected alloantibodies of Rh blood group system, the antibody specificity was anti-E 300 cases (56.18%), anti- cE 72 (13.48%), anti-D 66 (12.36%), anti-Ce 64 (11.99%), anti-c 16 2 cases (0.37%) were anti-D + G, anti-D + G + C and anti-G + C (0.19%). The detection rates of anti-E, anti-D, anti-G and anti-cE patients were compared with each other in transfusion history and pregnancy history respectively (P> 0.05). The overall detection rate of anti-D and anti-Ce in female patients was significantly higher than that in men (P <0.05). The detection rate of anti-cE in male patients was higher than that in male patients Female (P <0.05). CONCLUSION: The detection rate of alloantibodies in Rh blood group is lower than that in white people, of which the detection rate of anti-E is the highest. Pregnancy and blood transfusion are the main immune factors of alloantibodies produced by Rh blood group system. Rh antigens Homologous blood transfusion, from the source to reduce Rh blood group alloantibodies caused by blood transfusion reactions of great significance.