电子配血技术对减少输血患者Rh血型系统同种抗体产生的意义  

Electronic crossmatching based on Rh typing:reducing the production of Rh system alloantibody in blood transfusion recipients

作　　者：高凯旋 张少强[1] 杨元铭[1] 闫松霞 王莉存[1] 赵真[1] 井忠翠 王海燕[1] GAO Kaixuan;ZHANG Shaoqiang;YANG Yuanming;YAN Songxia;WANG Licun;ZHAO Zhen;JING Zhongcui;WANG Haiyan(Department of Blood transfusion,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院输血科,山东青岛266000

出　　处：《中国输血杂志》2021年第3期210-213,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨电子配血技术应用对减少受血者Rh血型同种抗体产生的意义。方法将本院2018年1月1日-2020年3月31日期间住院且仅输注去白悬浮红细胞的Rh(D)阳性的患者22 528人,将电子配血符合优先级Ⅰ级、Ⅱ级的患者21 334人设为对照组,将符合优先Ⅲ级的患者共1 194人设为试验组,对用血者和献血者进行ABO和Rh血型系统5种抗原(D、C、c、E、e)的血清学检测,并运用输血管理系统,建立Rh表型数据库。并对对照组和试验组进行输注红细胞过程中引入新的抗原相对应不规则抗体的产生率进行比较。结果 C抗原和e抗原所占的比例明显高于c和E抗原。同时表现型为DCCee和DCcEe的比率最高,表现型为Dccee和DCCEE的极为罕见。在本院输血患者达到优先Ⅰ级(85.2%)和Ⅱ级(9.5%)输血标准的比例达到94.7%,达优先Ⅲ级的输血比例仅为5.3%。对照组(n=21 334)中患者输血后产生Rh系统同种抗体共6人,比率小于0.001%;试验组(n=1 194)中患者输血后共24人出现与引入外来抗原相符的Rh系统同种抗体,比率为2.01%。试验组与对照组差异存在临床意义(P<0.01)。结论依据Rh抗原检测的电子配血技术可明显降低输血后Rh血型系统不规则抗体阳性率,从而有效的保证临床输血安全。Objective To study the application of electronic crossmatching(E-XM) based on Rh typing aimed at reducing the production of alloantibodies in blood recipients. Methods A total of 22 528 RhD positive patients, admitted to our hospital from Jan 1, 2018 to Mar 31, 2020, required the specific transfusion of leukocyte-depleted suspension red blood cells. Among which, 21 334 reached the priority level Ⅰ and Ⅱ by E-XM and were set as the control group, and 1 194 reached the priority level Ⅲ and were set as the experimental group. ABO and Rh(D, C, c, E and e antigens) blood group systems were serologically tested both in blood recipients and donors, and Rh phenotype database was established based on the blood transfusion management system. The incidence of irregular antibodies against the exposure of new antigens involved with RBC transfusions in the control group and the experimental group was compared. Results The proportion of antigen C and e was significantly higher than that of c and E. The frequency of DCCee and DCcEe were the highest, while that of Dccee and DCCEE were extremely low. 85.2% and 9.5% of the patients reached priority level Ⅰ and Ⅱ, respectively, and only 5.3% reached priority level Ⅲ. 6 patients(less than 0.001%) in the control group(n=21 334),developed Rh system alloantibodies after blood transfusion, and 24 patients(2.01%) in the experimental group(n=1194) developed Rh alloantibodies against the exposure of antigens after blood transfusion. There were significant differences between the experimental group and the control group(P<0.01). Conclusion The application of E-XM could minimize the incidence of Rh irregular antibodies after RBC transfusion in patients, which contributes to the safety in clinical blood transfusion.

关 键 词：Rh表型 不规则抗体 电子配血 

分 类 号：R457.11[医药卫生—治疗学]