Rh血型系统相容性输血在血液科的应用探讨  

Investigation of the application of Rh blood group system compatible blood transfusion in hematology department

作　　者：张鹏 李晗郡 李婧[2] 杨菁菁 方华 曾飞艳 雒红玉 向晓欢 Zhang Peng;Li Han-jun;Li Jing;Yang Jing-jing;Fang Hua;Zeng Fei-yan;Luo Hong-yu;Xiang Xiao-huan(Department of Blood Transfusion,Sichuan Mental Health Center-Mianyang Third People's Hospital,Mianyang 621000,Sichuan,China;Department of Blood Transfusion,Zitong County People's Hospital,Mianyang 621000,Sichuan,China)

机构地区：[1]四川省精神卫生中心·绵阳市第三人民医院输血科,四川绵阳621000 [2]梓潼县人民医院输血科,四川绵阳621000

出　　处：《四川生理科学杂志》2021年第8期1293-1296,1300,共5页Sichuan Journal of Physiological Sciences

基　　金：绵阳市卫健委2019年鼓励科研课题。

摘　　要：目的:探讨实施恒河猴(Rhesus monkey,Rh)血型系统相容性输血在血液科的应用效果.方法:选取本院2019年6月至2020年11月105例需输血治疗患者的血液样本和210例献血者血液样本,将输血患者行交叉配血实验,常规按ABO和RhD配血纳入对照组,加行Rh血型系统C、E、c、e配血则纳入实验组,观察Rh抗原分布、Rh血型表型分布、不规则抗体阳性率及分布情况.结果:105例血液样本中RhD阳性91例,占86.67%,RhD阴性14例,占13.33%,其中RhD阳性患者中以C、e抗原占比最高,RhD阴性患者中则以c、e占比较高;在Rh血型抗原表型分布中以CCDee、CcDEe占比最高,分别为27.62%、20.95%;ccdEe最少,占0.95%;行交叉配血实验发现实验组不规则抗体阳性率明显低于对照组(P<0.05),在不规则抗体阳性类型中以抗-E占比最高,抗-C,抗-Ce、抗-Ec占比较少.结论:血液科实施Rh血型系统相容性输血可明显减少产生免疫抗体的风险,降低输血不良事件的发生,同时,有助于完善Rh血型系统相容性输血体系.Objective:To explore the application effect of Rhesus monkey(Rh)blood group system compatible blood transfusion in hematology department.Methods:From June 2019 to November 2020,105 blood samples from patients who needed blood transfusion and 210 blood samples from blood donors were selected.Blood matching experiments were performed on patients who received blood transfusion,and routine blood matching according to ABO and RhD was included in the control group,while additional blood matching according to Rh blood group system C,E,c and e was included in the experimental group.Rh antigen distribution,Rh blood group phenotype distribution,irregular antibody positive rate and distribution were observed.Results:Among 105 blood samples,91 cases were RhD positive,accounting for 86.67%;and 14 cases were RhD negative,accounting for 13.33%.Among them,C and e antigens accounted for the highest proportion among RhD positive patients,while c and e antigens accounted for a higher proportion among RhD negative patients.In the phenotype distribution of Rh blood group antigen,CCDee and CcDEe accounted for the highest proportion,which were 27.62%and 20.95%respectively;CcdEe is the least,accounting for 0.95%;Cross-matching experiment showed that the positive rate of irregular antibody in the experimental group was significantly lower than that in the control group(P<0.05).Among the irregular antibody positive types,anti-E accounted for the highest proportion,while anti-C,anti-Ce and anti-Ec accounted for less.Con clusi on:The implementation of Rh blood group system compatible transfusion in hematology department can reduce the risk of producing immune antibodies and the incidence of transfusion adverse events,and help to improve Rh blood group system compatible transfusion system.

关 键 词：红细胞血型系统 RH血型系统 相容性输血 Rh血型表型 不规则抗体 输血反应 

分 类 号：R44[医药卫生—诊断学]