96例Rh血型抗体检测及分析  

Detection and analysis on 96 cases of Rh blood group antibody

作　　者：方晓蕾[1] 梅礼军[1] 刘锋[1] 张杰[1] 禹梅[1] 陈蕾[1] 

机构地区：[1]安康市中心医院输血科,陕西安康725000

出　　处：《国际检验医学杂志》2015年第19期2782-2783,2786,共3页International Journal of Laboratory Medicine

基　　金：陕西省科技厅科研课题项目(2013AKZD03-07)

摘　　要：目的调查Rh血型抗体的检出率及其特异性分布特点,分析Rh血型抗体的临床意义及产生规律。方法采用微柱凝胶抗球蛋白技术筛查和鉴定红细胞血型不规则抗体,对鉴定为Rh血型抗体者,采用单克隆抗-D、抗-C、抗-c、抗-E、抗-e鉴定红细胞Rh血型抗原,以确认抗体的准确性;检测抗体的效价、Ig类型及37℃反应性,以明确其临床意义;询问孕产史、输血史,如果为新生儿,检测其母亲血浆中是否有相同特异性的抗体,以分析抗体产生的原因。结果就诊者109 000例,共检出Rh血型抗体96例,检出率为0.088%,其中有妊娠史者68例,有输血史者5例,既有妊娠史又有输血史者6例,抗体来自母体的新生儿17例;抗体的特异性为：抗-E 65例（67.710%）、抗-cE 12例（12.500%）、抗-D 8例（8.330%）、抗-c 7例（7.291%）、抗-C 2例（2.083%）、抗-e 2例（2.083%）;96例Rh血型抗体均为IgG,或IgG＋IgM类,37℃均可与具有相应抗原的红细胞反应,抗体效价介于4~2 048。结论抗-D的检出率呈逐步降低趋势;在检出的Rh血型抗体中,抗-E和抗-cE占绝对多数;妊娠和输血引起的同种免疫是Rh血型抗体产生的主要原因;新生儿自母体被动获得的Rh血型抗体是Rh-新生儿溶血病最主要的致病抗体。Objective To analyze the positive rate of specific distribution characteristics in Rh blood group antibody,analyze the clinical significance of Rh blood group antibody and rules. Methods The micro column gel anti globulin technique was used to screen and identify irregular red blood cell antibodies, for patients with Rh blood group antibody,monoelonal anti D,anti C, anti c, anti-E,anti e were used to identify Rh blood group antigen to confirm the accuracy of detection. The antibody titer,Ig type and 37 ℃. reactive were used to determine its clinical significance. Through asking pregnancy history, history of blood transfusion, under standing whether the same specificity of the antibody in maternal plasma if the patient was newborn,the causes of antibody were an alyzed. Results In 109 000 patients,Rh blood group antibodies were detected in 96 cases,the positive rate was 0. 088% ,which has a history of pregnancy in 68 cases, 5 cases had history of blood transfusion,both pregnancy history and history of blood transfusion in 6 cases, 17 cases of neonatal maternally derived antibody. Antibody specificity： 65 cases of anti-E（67. 710%）,12 cases of anti-cE （12. 500%） ,8 cases of anti-D （8. 330%） ,7 cases of anti-c（7. 291%） ,2 cases of anti C （2. 083%） ,2 cases of anti-e（2. 083%）. 96 cases of Rh blood group antibodies were IgG or IgG＋ IgM class, 37 ℃reaction could be with the corresponding antigen of red blood cell,antibody titer between 4-2 048. Conclusion Anti D detection rate shows a trend of gradually decreasing. In Rh blood group antibody detection,anti E and anti cE account for an absolute majority. Alloimmune caused by pregnancies and blood transfusion is the main reason of Rh blood group antibody production from Rh blood group antibody. Neonatal maternal passive getisa Rh HDN is the main pathogenic antibody.

关 键 词：RH血型抗体 不规则抗体 新生儿溶血病 微柱凝胶抗球蛋白试验 

分 类 号：R446.6[医药卫生—诊断学]