地中海贫血患者Rh配型输血研究  

A study on Rh-matched transfusions in patients with thalassemia

作　　者：党鑫堂[1] 伍昌林[1] 彭进 吴筱莹[3] 李妙珊[1] 朱奕[1] 邵超鹏[1] 

机构地区：[1]深圳大学第一附属医院深圳市第二人民医院,广东深圳518035 [2]西安市卫生学校 [3]深圳市血液中心

出　　处：《中国输血杂志》2015年第7期800-803,共4页Chinese Journal of Blood Transfusion

基　　金：2014年深圳市科技创新项目(JCYJ20140414170821221);深圳市第二人民医院院级重点实验室项目

摘　　要：目的本文探讨我国地中海贫血患者Rh配型输血的可行性。方法对40例β-地中海贫血患者采用PCR-SSP技术进行RhCcEe基因分型,连续至少3个月采用微柱凝胶卡方法筛选供者进行CcEe同型输血,其中1例ccEe和2例ccEE表型患者,当供者筛选超过30袋无同型血时,输注CcEe或CCee供者红细胞。3个月后对所有患者均进行卡式CcEe检测,并与配型前的检测结果进行比较。结果 37例完全同型输血的患者,卡式CcEe结果清晰,无自体细胞与供者细胞分层现象,提示基因分型结果未发生假阳性或假阴性。另外3例无法每次同型输血的患者,卡式检测CcEe抗原时,再次出现分层现象,结果无法阅读,但对比基因分析结果,可清楚判断患者近期所输供者血的CcEe表型与实际相符。结论 RhCcEe基因分型技术可应用于长期依赖输血的地中海贫血患者进行Rh配型输血,地贫患者的自身细胞并不影响微柱凝胶卡RhCcEe血清学检测。Objective To explore the feasibility of Rh-matched transfusions in patients with thalassemia in China.Methods Rh Cc Ee were genotyped for 40 patients with beta thalassemia using PCR-SSP. The donor red cell packages of the same Cc Ee phenotypes were screened for transfusion continuously for at least 3 months through a microcolumn gel card method. For one case of cc Ee and 2 cases of cc EE patients,common Cc Ee or CCee red cell packages were issued after 30 donors were screened without the same phenotypes. Three months later,all patients were phenotyped with gel cards for Cc Ee again,and the results were compared with those before Rh-matched transfusion. Results Thirty seven patients underwent Rhmatched transfusion every time. Their Cc Ee antigens were tested and given clear results in the gel cards. No stratification occurred in autologous cells and donor cells,which indicated that the genotyping results did not produce false positives or false negatives. The stratification appearance,however,occurred in three patients who could not undergo successive Rh-matched transfusion every time. By comparing their genotyping results with the those of the rest of the patients,their Cc Ee phenotypes from the recent blood infusion were clearly consistent with the actual phenotypes. Conclusion The Rh Cc Ee genotyping technique can be applied to Rh-matched transfusion for transfusion dependent patients with thalassemia. Rh Cc Ee phenotyping by microcolumn gel card does not affect the autologous cells of patients with thalassemia.

关 键 词：地中海贫血 RhCcEe Rh配型输血 

分 类 号：R457.11[医药卫生—治疗学]