孕产妇Rh抗原表型分布及其在Rh新生儿溶血病预防中价值探讨  

Rh Antigen Phenotype Distribution in Pregnant Women and its value in prevention of Rh neonatal hemolytic disease

作　　者：强新晨 杨华莹 邵俊良 QIANG Xin-chen;YANG Hua-ying;SHAO Jun-liang(Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214023,China)

机构地区：[1]南京医科大学附属无锡人民医院,江苏无锡214023

出　　处：《中国实验诊断学》2021年第5期702-705,共4页Chinese Journal of Laboratory Diagnosis

基　　金：江苏省输血协会英科新创科研基金资助(项目编号:JS20190022)。

摘　　要：目的通过对孕妇Rh抗原表型分布及新生儿Rh表型、新生儿溶血病试验、红细胞不规则抗体特异性鉴定及效价测定进行回顾性分析,为Rh新生儿溶血病(Rh-HDN)早期诊断提供实验依据。方法对南京医科大学附属无锡人民医院2018年5月至2020年9月用Rh分型微柱凝胶卡测定的8801例孕产妇Rh表型结果进行统计,并对同期12例Rh-HDN患儿的Rh分型、新生儿溶血3项试验检测结果进行分析。结果8801例孕产妇中,RhD阳性为8760例、阴性41例。RhD阳性孕产妇表型分布规律为:CCee(40.93%)>CcEe(38.3%)>Ccee(10.32%)>ccEE(5.26%)>ccEe(3.61%)>CCEe(0.87%)>CcEE(0.39%)>ccee(0.32%),CCDEE未检出;RhD阴性孕妇中Rh表型分布为,Ccee(43.93%)>ccee(36.6%)>CCee(7.3%)=ccEe(7.3%)>CcEe(4.87%)。新生儿溶血试验共检出Rh血型特异性抗体12例:抗-D 8例,抗-E 3例,抗-c1例,D抗原以外抗体占总检出抗体33.3%。结论Rh抗原表型检测纳入常规产前检查对预测Rh-HDN发生有一定价值。对有输血史、不明原因流产史、死胎、HDN既往史的孕产妇,有必要对夫妻双方进行Rh抗原表型检测。孕期连续监测不规则抗体效价,为预防胎儿发生Rh-HDN提供早期干预依据。Objective To investigate the distribute laws of Rh phenotype antigen in pregnant women,Rh phenotype antigen in newborn,hemolytic disease test of newborn,and specificity identification and titer determination of irregular antibody of red blood cell and to provide scientific evidence for early diagnosis of Rh HDN.Methods The Rh phenotype detection results of 8801pregnant women cases by Rh micro column gel detection card from May 2018to Sep 2020 were analyzed retrospectively,as well as three items of hemolysis test for 12newborn with RH HDNduring the same period.Results Among the 8801pregnant women,8760and 41cases were RhD positive and negative.The distribution law of RhD positive case were as follows:CCee(40.93%)>CcEe(38.3%)>Ccee(10.32%)>ccEE(5.26%)>ccEe(3.61%)>CCEe(0.87%)>CcEE(0.39%)>ccee(0.32%)>CCDEE(0).The distribution law for the 41RhDnegative pregnant cases were as follows:Ccee(43.93%)>ccee(36.6%)>CCee(7.3%)=ccEe(7.3%)>CcEe(4.87%).A total of 12cases was observed in serological testing in hemolytic disease of newborn,including of anti-D 8cases,anti-E3cases andanti-c1case.Conclusion It is important for Rh antigen phenotype being included inroutine prenatal examination,which is helpful to know the occurrence of Rh-HDN.It’s necessary to detect Rh antigen phenotype for both husband and wife,especially for the pregnantwith blood transfusionhistory,unexplained abortion,stillbirth,HDNhistory and etc.It will provide early intervention basis to monitore irregular antibody titer in Rh-HDN in fetus.

关 键 词：RH新生儿溶血病 Rh抗原表型 不规则抗体 

分 类 号：R722.18[医药卫生—儿科]