20例输注D^(el)型红细胞的RhD阴性受者的回顾性分析  

Retrospective Analysis of 20 RhD-negative Recipients Transfused with D^(el) Red Blood Cells

作　　者：张建军[1] 刘忠[2] 姚余有[3] 

机构地区：[1]安徽医科大学,合肥230032 [2]安徽省血液中心 [3]安徽医科大学公共卫生学院

出　　处：《临床输血与检验》2011年第3期214-217,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨Del型红细胞是否诱导RhD阴性受者产生同种免疫反应。方法用吸收放散试验鉴定Del型血液,对临床输注Del型红细胞的患者进行追踪,采集输血后1周～1年的患者血液标本,RhD抗原初筛阴性的标本采用间接抗球蛋白试验(IAT)进行阴性确认。对患者血清采用凝聚胺法、间接抗球蛋白试验和微柱凝胶法筛查不规则抗体,然后对筛查阳性标本用谱细胞进行不规则抗体鉴定,并进行效价测定。结果采集到输注Del红细胞的RhD阴性受血者样本20例,男性10例,女性10例,女性均有孕产史。Del型受血者5例,男性2例,女性3例,输注Del红细胞后未发生输血反应,不规则抗体筛查阴性。真实RhD阴性受血者15例,男性8例,女性7例,8例男性和5例女性患者输注Del红细胞后未发生输血反应,不规则抗体筛查阴性;2例妊娠女性抗-D为阳性,未出现输血反应。结论 Del型个体未检出抗-D,产生抗-D的个体未检出Del型。Del红细胞导致RhD阴性受者产生同种免疫反应的概率可能很低。Objective To determine whether D antigens in Del individuals expresses alloimmunization.Methods Del phenotype was detected by absorption-elution test.We tracked 20 RhD-negative recipients transfused with Del red blood cells.Their blood samples were collected at the stage from one week to one year after transfusion.RhD negative blood samples were initially screened by routine serological test and confirmed by indirect antiglobulin(IAT).Irregular antibodies were screened by manual polybrene(MP),indirect antiglobulin test(IAT) and microtubes gel test(MGT) for the serum of samples.Antibody titer and Ig-types were identified by O-panel cells for those positive anti-Rh samples.Results Among the 20 Rh-negative recipients transfused with Del variants,10 individuals were male and the others were female with history of pregnancy.The results of adsorption-elution tests for 20 patient samples showed that 5 were Del and 15 were true Rh-negative.Two men and three women identified as Del showed no reactions after transfusion,and irregular antibodies were not detected in their serum.Among the 15 true Rh-negative samples,13 samples from eight men and five women gave the same results as the Del samples.The other two women were identified as positive with irregular antibodies,and there were no evidence of transfusion reactions.Conclusions Anti-D antibody is not detected among Del phenotype individuals and Del phenotype is not found in anti-D antibody producing individuals.The RhD-negative recipients are not at the risk of alloimmunization after transfused with Del red blood cells.

关 键 词：RH血型 Del型 抗-D抗体 

分 类 号：R44[医药卫生—诊断学]