青岛地区孕产妇Rh系统血型抗原分布和Rh系统新生儿溶血病相关性分析  

Correlation between Rh blood group antigen profiles in pregnant women and hemolytic disease of the newborn in Qingdao area:A retrospective study

作　　者：邵长峰[1] 韩乐乐[1] 刘政 张长凯 宗朋 黄祖洲 张少强[1] SHAO Changfeng;HAN Lele;LIU Zheng;ZHANG Changkai;ZONG Peng;HUANG Zuzhou;ZHANG Shaoqiang(Department of Transfusion,the Ajfiliated 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10期1109-1112,共4页Chinese Journal of Blood Transfusion

摘　　要：目的探讨青岛地区孕产妇Rh系统血型抗原分布和Rh系统新生儿溶血病分布特点。方法选取2016年10月~2020年2月在本院10597例孕产妇为研究对象,进行ABO、Rh(D、C、c、E、e)血型抗原和不规则抗体检测,抗体阳性时进行抗体鉴定,根据输血史和妊娠史对孕产妇Rh系统的不规则抗体进行统计分析。12例确诊的Rh系统新生儿溶血病新生儿中,回顾性分析ABO、Rh血型抗原和不规则抗体、抗体性质、新生儿溶血病试验、血常规等相关检测结果。结果在10513例Rh阳性孕产妇中,常见表型依次为CCee>CcEe>Ccee>ccEE>ccEe,84例RhD阴性孕产妇中,常见表型依次为ccee>Ccee>CCee>ccEE>ccEe;10597例孕产妇中不规则抗体阳性率为1.06%(112/10597),其中Rh血型抗体检出率最高为56.25%(63/112),抗体阳性孕产妇中,64例Rh系统血型抗体和其他抗体按照输血史(P<0.05)和妊娠史(P<0.05)进行比较,统计具有差异性;12例新生儿确诊为Rh系统新生儿溶血病,分别为IgG抗-E 6例,IgG抗-D 3例,IgG抗-cE 1例,IgG抗-C 1例,IgG抗-c 1例,其中3例新生儿病情严重进行换血治疗。结论随着国家二孩政策的开放,Rh系统新生儿溶血病的发病率增加,对育龄期输血的女性进行ABO、RhD、E、C、c、e 7种抗原匹配性输注,同时在妊娠期进行监测,对预测有Rh系统新生儿溶血病且情况危急的孕产妇,建议临床采取提前终止分娩,并备Rh表型匹配的新鲜血液,为抢救新生儿换血具有重要的临床意义。Objective To investigate the profile of Rh blood group antigen in pregnant women and hemolytic disease of the newborn(HDN)in Qingdao area.Methods 10597 pregnant women admitted in our hospital during October 2016 to February 2020 were selected and the ABO,Rh blood group system antigen(D,C,c,E,e)and the irregular antibody were detected,and positive antibody was further identified.The irregular antibody of Rh blood group in pregnant women was statistically analyzed according to the history of blood transfusion and pregnancy.Twelve HDN cases were studied,and the results of ABO,Rh blood group antigen and irregular antibody,antibody property identification,HDN test and blood routine test were retrospectively analyzed.Results Among 10513 cases of Rh-positive pregnant women,the common phenotype was CCee>CcEe>Ccee>ccEE>ccEe;among 84 cases of Rh-negative pregnant wome,the common phenotype was ccee>Ccee>CCee>ccEE>ccEe.The positive rate of irregular antibody was 1.06%(112/10597)in 10597 pregnant women,of which the Rh antibody was the highest,rated at 56.25%(63/112).For 64 pregnant women with positive antibodies,antibodies against Rh system were different from those against other systems when stratified by the history of blood transfusion(P<0.05)and pregnancy(P<0.05).Twelve neonates were diagnosed with Rh-HDN,with IgG anti-E in 6 cases,IgG anti-D 3,IgG anti-cE 1,IgG anti-C 1 and IgG anti-c 1.Among them,3 were seriously ill and treated with blood exchange.Conclusion As two-child policy was implemented,the incidence of Rh HDN had increased.ABO,RhD,C,c,E and e matched transfusion should be administered for women at childbearing age.Meanwhile,clinical termination of delivery was recommended for pregnant women,who probably develop Rh-HDN and are with critical situation.Rh phenotype matched fresh blood should be prepared,which has great clinical significance for rescuing newborns.

关 键 词：RH血型系统 不规则抗体 新生儿溶血病 孕产妇 

分 类 号：R457.11[医药卫生—治疗学] R556.63[医药卫生—临床医学]