产妇Rh血型系统抗体的检出特点分析其与新生儿溶血病之间的关系并制定临床输血应对对策分析  

Maternal Rh Blood Group System Antibody Detection Characteristics Analysis and Its Relationship with Neonatal Hemolytic Disease and the Development of Clinical Transfusion Coping Strategies Analysis

作　　者：曲执 郭美玲 QU Zhi;GUO Meiling(Huludao Central Blood Station,Huludao 125000,China;Huludao Central Hospital,Huludao 125000,China)

机构地区：[1]葫芦岛市中心血站,辽宁葫芦岛125000 [2]葫芦岛市中心医院,辽宁葫芦岛125000

出　　处：《中国医药指南》2022年第21期85-87,共3页Guide of China Medicine

摘　　要：目的分析产妇Rh血型系统抗体的检出特点,并且分析其与新生儿溶血病之间的联系,制定临床输血的正确方式。方法选入我院于2016年12月至2019年12月期间我院收治的105例孕产妇,依据抗体Ig的种类进行抗球蛋白或者是凝柱凝胶抗蛋白的方式,检测进行检查的血清、谱红细胞和与自身红细胞反应结果;检查和分析Rh血型抗体的有效价、免疫球蛋白的种类和在37℃进行反应,以及所取得临床结果;检测孕产妇的红细胞D、C、E、c、e抗原并且确定孕产妇Rh血清学分型;新生儿进行溶血病的相关试验,确定新生儿和母体血清的关系,并且需要分析抗体的产生和妊娠史以及输血史之间的关系。结果105例孕妇Rh血型抗体在早期进行不规则抗体阳性标本的检出率为50例(47.62%),20例为妊娠史(40.00%),妊娠超过两次以上的13例(26.00%),输血史4例(8.00%);30例为抗-E,8例为抗-D、6例为抗-c、4例为抗-cE、2例抗-C;IgG28例(56.00%),IgG+IgM15例(30.00%),IgM7例(14.00%),在37℃下都会和相应的红细胞产生凝集反应;8例新生儿的新生儿溶血病血清抗体和母亲相同。结论通过试验可知,造成Rh血型抗体的主要原因为妊娠或者输血等,来源于母亲的Rh血型抗体会造成Rh-HDN,在输血的时候应当检测夫妇RhCE抗原常规检测,选择相同的血型进行输血,以此减少意外抗体的概率。Objective To analyze the detection characteristics of maternal Rh blood group system antibodies,and to analyze the relationship between maternal Rh blood group system antibodies and neonatal hemolytic disease,and to formulate the correct way of clinical transfusion.Methods A total of 105 cases of pregnant admitted to our hospital from December 2016 to December 2019 were selected.Antiglobulin or coagulation column gel anti-protein method was used according to the type of antibody Ig to detect the serum,spectrum cells and reaction results with autoerythrocytes.To examine and analyze the effective value of Rh antibody,the type of immunoglobulin and the reaction at 37℃,as well as the clinical results obtained;To detect D,C,E,c and e antigens of erythrocytes of pregnant and pregnant women and to determine their Rh serum credit type;Neonatal hemolytic disease related experiments were conducted to determine the relationship between neonatal and maternal serum,and the relationship between antibody production and pregnancy history and blood transfusion history was analyzed.Results The detection rate of 105 pregnant women with Rh blood group antibody in early irregular antibody positive samples was 50 cases(47.62%),20 cases had a history of pregnancy(40.00%),13 cases(26.00%)had more than two pregnancies,and 4 cases(8.00%)had a history of blood transfusion.There were 30cases of anti-E,8 cases of anti-D,6 cases of anti-c,4 cases of anti-cE and 2 cases of anti-C.There were 28 cases(56.00%)of IgG,15 cases(30.00%)of IgG+IgM,and 7 cases(14.00%)of IgM,all produce agglutination reaction with corresponding erythrocytes at 37℃.The serum antibody of 8neonates with neonatal hemolytic disease was the same as that of the mother.Conclusion According to the test,the main cause of Rh blood group antibody is pregnancy or blood transfusion,and the Rh blood group antibody from the mother can cause Rh-HDN.During the blood transfusion,the routine detection of RhCE antigen should be detected for the couple,and the same blood group should be

关 键 词：RH血型系统 新生儿 溶血病 凝柱凝胶抗蛋白 抗球蛋白 

分 类 号：R556.6[医药卫生—血液循环系统疾病]