孕妇产前红细胞血型不规则抗体筛查及鉴定分析  

Prenatal screening and identification of irregular antibodies of erythrocyte blood type in pregnant women

作　　者：韩斌 朱于莉 冯智慧 Han Bin;Zhu Yuli;Feng Zhihui(Institute of Transfusion Medicine,Qingdao Blood Center,Qingdao 266071,Shandong Province,China)

机构地区：[1]青岛市中心血站输血医学研究所,266071

出　　处：《国际输血及血液学杂志》2020年第1期67-70,共4页International Journal of Blood Transfusion and Hematology

摘　　要：目的探讨孕妇红细胞血型不规则抗体的分布及特点。方法选择2016年1月至2018年6月,于青岛市中心血站进行红细胞血型不规则抗体鉴定的130例孕妇为研究对象。其年龄为25~42岁,中位年龄为32岁。对这130例孕妇的ABO及Rh血型进行鉴定,同时对其Rh血型系统不规则抗体效价采用试管法进行测定,红细胞血型不规则抗体筛查与鉴定采用微柱凝胶法或者试管法。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求,并且与所有受试者签署临床研究知情同意书。结果①纳入研究130例孕妇中,A、B、O、AB型血型为44例(33.8%)、48例(36.9%)、27例(20.8%)和11例(8.5%);Rh阳性为90例(69.2%),Rh阴性为40例(30.8%)。②本研究130例孕妇的血清标本中,Rh、MNSs、P、Lewis血型系统不规则抗体为71例(54.6%)、28例(21.5%)、3例(2.3%)和14例(10.8%),抗-HI为4例(3.1%)。③71例检出Rh血型系统不规则抗体的孕妇中,检出率最高的抗体效价为2,其检出率为26.8%(19/71)。抗体效价系512的孕妇为1例,其Rh血型为阴性,既往有RhD阳性红细胞制品输血史。结论青岛市红细胞血型不规则抗体阳性孕妇的不规则抗体分布,以Rh血型系统为主,其次是MNSs血型系统。对孕妇进行产前红细胞血型不规则抗体筛查和鉴定,有利于保证孕妇输血安全,以及降低新生儿溶血病(HDN)的发生风险。Objective To investigate the distribution and characteristics of irregular antibodies of erythrocyte blood type in pregnant women.Methods From January 2016 to June 2018,a total of 130 pregnant women who were identified for irregular antibodies of erythrocyte blood type in Qingdao Blood Center,were selected as the subjects.The age of the pregnant women was 25-42 years,and the median age was 32 years.ABO and Rh blood group identification of pregnant women,and irregular antibody titers of Rh blood group system were determined by test tube method.The screening and identification of irregular antibodies of erythrocyte blood type were used micro-column gel agglutination or tube test method.The procedure followed in this study was in line with the requirements of the revised World Medical Association Declaration of Helsinki in 2013.And informed consents were obtained from all the subjects.Results①Among the 130 pregnant women,there were 44 cases(33.8%),48 cases(36.9%),27 cases(20.8%)and 11 cases(8.5%)of blood group A、B、O and AB,respectively.And 90 cases(69.2%)were Rh positive and 40 cases(30.8%)were Rh negative blood group.②Among the serum samples of 130 pregnant women,71 cases(54.6%),28 cases(21.5%),3 cases(2.3%)and 14 cases(10.8%)were in Rh,MNSs,P and Lewis blood group system respectively,and 4 cases(3.1%)were anti-HI.③Among 71 pregnant women who were detected irregular antibodies of Rh blood group system,antibody titer with the highest detection rate was 2,whose detection rate was 26.8%(19/71).One pregnant woman had an antibody titer of 512.Her Rh blood group was Rh negative.And she had previously received RhD positive red blood cells transfusion.Conclusions In Qingdao City,the irregular antibody distribution in pregnant women with positive irregular antibodies of erythrocyte blood type is dominated by the Rh blood system,followed by the MNSs blood system.Prenatal screening and identification of irregular antibodies of erythrocyte blood group in pregnant women is conducive to ensure the safety of pregnant wo

关 键 词：血型抗原 抗体 孕妇 幼红细胞增多症 胎儿 输血 RH-HR血型系统 MNSS血型系统 不规则抗体 

分 类 号：R446[医药卫生—诊断学] R714[医药卫生—临床医学]