受血者输血中Rh血型E抗原对患者机能免疫功能影响  

Effect of Rh Blood Group E Antigen on Immune Function in Patients with Blood Transfusion

作　　者：马经琼 朱振新[2] 

机构地区：[1]荆州市中心医院输血科,湖北荆州434000 [2]荆州市中心医院肝胆外科,湖北荆州434000

出　　处：《标记免疫分析与临床》2017年第1期60-63,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨受血者输血中Rh血型E抗原对患者机能免疫功能影响。方法收集2014年3月至2016年7月200组受-供血者的血标本,其中100组受-供血者E抗原均呈阴性为A组,另100组受血者E抗原呈阴性、供血者E抗原呈阳性为B组。受血者输血前后分别检测血清白细胞介素-2(IL-2)、免疫球蛋白M(Ig M)、Ig G抗体及血中T淋巴细胞亚群(CD4^+、CD8^+)。结果 A组输血前后血清IL-2、Ig M及Ig G抗体水平均无明显变化。B组输血后IL-2、Ig M及Ig G抗体水平均呈先逐渐升高,后逐渐降低的过程,均在输血后5d达到最高,在输血后18d基本恢复至输血前水平。B组输血后3、5、10d IL-2、Ig M及Ig G抗体水平均明显高于A组(P均<0.05);A组输血前后血清CD4^+、CD8^+细胞数无明显变化。B组输血后CD4^+细胞数均呈先逐渐升高后降低,CD8^+细胞逐渐降低后升高,均在输血后3d达到最高和最低,在输血后18d基本恢复至输血前水平;B组输血后5、10d CD4^+细胞数均明显高于A组,CD8^+细胞低于A组(P均<0.05)。结论Rh(E)抗原阴性的受血者在输注E抗原阳性血制品后,其机能免疫功能将出现有时间限制的改变;临床应加强对受-供血者的Rh(E)抗体的检测,配型满意后方进行输血,提高临床输血的科学性、合理性与安全性。Objective To investigate the effect of Rh blood group E antigen on the immune function in patients with blood transfusion. Methods The donor / recipientblood samples of 200 groups were collected from M arch2014 to July 2016,100 of which were Rh（ E） negative for either as group A,the other 100 pairswere Rh（ E） negative for recipient and Rh（ E） positive for donor as group B. Serum interleukin-2（ IL-2）,immunoglobulin M（ Ig M） antibody and blood T lymphocyte subsets（ CD4~＋,CD8~＋） were detected before and after blood transfusion. Results There was no significant change of serum IL-2,Ig M and Ig G antibody in group A before and after transfusion. The levels of IL-2,Ig M and Ig G in group B increased gradually after transfusion,and reached the peak at 5 days after transfusion,and recovered to the level of pretransfusion 18 days after transfusion. The levels of IL-2,Ig M and Ig G antibody in group B were significantly higher than those in group A at 3d,5d and 10 d after transfusion（ P 〈0. 05）. There was no significant change in CD4~＋and CD8~＋cells in group A before and after transfusion. The number of CD4~＋cells in group B increased gradually after transfusion,and then decreased. It peaked at Day 3. CD8~＋in group B decreased gradually after transfusion,reached the lowest at Day 3,then increased. Both CD4~＋and CD8~＋recovered to the level of pretransfusion 18 days after transfusion. CD4~＋cells of group B was significantly higher than that of group Aat Day 5 and Day 10. CD8~＋cells of group B w as significantly low er than that of group A（ P 〈0. 05）.Conclusion Rh（ E） negative recipientsreceived transfusion from Rh（ E） positive blood products, the immunogenicity w ill have time limited change. A strict,extended donor-recipient red-blood-cell matching is highly recommendedin order to improve the safety of blood transfusion.

关 键 词：输血 RH血型 E抗原 免疫功能 

分 类 号：R446.6[医药卫生—诊断学] R457.1[医药卫生—临床医学]