RhE抗原分布与临床输血关系的研究  

Study on relationship between distribution on RhE of blood type in population and clinical transfusion

作　　者：陆紫敏[1] 祖亚钧[1] 梁萍[1] 方琦[1] 李雪晨[1] 纪黎明[1] 

机构地区：[1]同济大学附属同济医院输血科,上海200065

出　　处：《临床血液学杂志（输血与检验）》2012年第4期479-481,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：上海市卫生局科研课题资助项目(No:2010046);上海市公共卫生重点学科建设计划资助(No:12GWZX0202)

摘　　要：目的:观察RhE抗原分布,探讨其抗原在临床输血中的影响。方法:采用血清免疫学方法对13200例临床受血者和献血员进行RhE、e表型鉴定,并对其中3613例RhE血型阴性者接受RhE阳性血液后的血液样本进行不规则抗体筛查,所有入组患者均于输血前后血红蛋白、红细胞、网织红细胞、血清胆红素及临床症状动态观察。结果:①Dee表型最为多见,占51.47%;在3613例RhE阴性受血者中检出不规则抗体共26例,其中抗-E抗体9例,自身抗体4例,同种特异性抗体22例;②3次以上输血组与3次以下输血组比较检出不规则抗体阳性率差异有统计学意义(P<0.01);③3次以下输血组输血后血红蛋白、红细胞较输血前有明显提高(P<0.01)。结论:江苏、浙江地区汉族人群中的RhE抗原阴性率远远高于RhD抗原阴性率;不规则抗体产生与输血频率关系密切;RhE阴性患者接受RhE阳性血液的风险较大。建立输血前常规检测RhE抗原及RhE同型输注,对保证临床安全、有效的输血治疗是具有重要的临床意义。Objective：To observe the distribution on RhE antigen in order to explore the impact of its antigen in clinical transfusion.Method：Rh（E）,（e）were identified on 13 200patients of blood donee and donors by serological methods.We did the irregular antibody screening on blood samples of 3613patients with RhE antigen-negative accepting blood of RhE positive and observed the change of hemoglobin,red blood cell,reticulocytes,serum bilirubin before and after transfusion on all patients enrolled in all groups.Result：①Dee phenotype was most common,which was 51.47%.The irregular antibodies were detected from 26among 3 613RhE negative blood recipients.9 cases had anti-E antibody and 4had autoantibodies.22cases were specific alloantibodies.②The positive rate using more 3times transfusion was higher than that using less 3times transfusion（P〈0.05）.③The index of the hemoglobin and red blood cell in less of 3times transfusion group after transfusion were higher than those before transfusion.Conclusion：RhE antigen negative rate of Han population in region of Jiangsu,Zhejiang is significantly higher than RhD antigen negative rate.The occurrence of irregular antibodies could be significantly related with the frequency of transfusion.The RhE negative patients would have the higher risk to accept RhE positive blood.It should be very important to have the routine test on RhE antigen and check the same type of RhE before transfusion,which could ensure safety and effective blood transfusion.

关 键 词：RhE血型 不规则抗体 输血 抗原性 

分 类 号：R457.1[医药卫生—治疗学]