亚洲型DEL母亲产生抗-c致新生儿溶血病的母子输血救治  

Hemolytic disease of the newborn caused by anti-c in puerperant of Asian-type DEL treated by transfusion:a case report

作　　者：姚文娟 高珺 穆启明 舒群峰 YAO Wenjuan;GAO Jun;MU Qiming;SHU Qunfeng(Renmin Hospital,Shiyan,Hubei Medical College,Shiyan 442000,China;Shiyan Central Blood Station)

机构地区：[1]湖北医药学院附属人民医院,湖北十堰442000 [2]十堰市中心血站

出　　处：《中国输血杂志》2024年第3期352-356,共5页Chinese Journal of Blood Transfusion

摘　　要：目的 探讨1例亚洲型DEL母亲产生抗-c引起的新生儿溶血病的母子输血救治方案。方法 盐水试管法鉴定母子ABO血型、Rh表型;经典抗人球蛋白法进行母亲RhD阴性确认、RhD吸收放散试验;经典抗人球蛋白法、抗人球蛋白卡式法和凝聚胺法进行母亲意外抗体筛查及鉴定、抗体效价检测、交叉配血试验;新生儿溶血3项试验使用抗人球蛋白卡式法;RHD基因分型采用商品化RHD阴性鉴定基因检测试剂盒(PCR-SSP法)进行产妇RHD基因分型。结果 产妇Rh血清学表型CCee, DEL基因检测结果RHD^(*)1227A,产生抗-c;患儿Rh血清学表型DCcEe,直抗阳性,红细胞放散阳性,结合母亲孕产史、患儿临床表现和血液检查结果,诊断为抗-c引起的新生儿溶血病。结论 亚洲型DEL母亲产生抗-c并引起新生儿溶血病的患儿选择Rh表型DCCee红细胞输注,母亲选择Rh表型CCee冰冻解冻去甘油红细胞输注,输血有效。Objective To explore a transfusion therapeutic plan for hemolytic disease of the newborn(HDN)caused by anti-c antibodies in mother of Asian-type DEL.Methods The ABO blood type and Rh phenotype of the mother and child were determined using the saline tube method.The mother′s RhD negativity was confirmed through classical anti-human globulin testing and RhD adsorption-elution test.The mother′s unexpected antibodies were screened and their titers were measured using classical anti-human globulin testing,antibody card test and polyamine method.Cross-matching was conducted.The three hemolysis tests were performed by antibody card test.The mother′s RHD gene typing was conducted using a commercially available RHD negative identification gene detection kit(PCR-SSP method).Results The mother exhibited a CCee Rh serological phenotype,and the DEL gene test confirmed the presence of RHD^(*)1227A,indicating the production of anti-c antibodies.The infant displayed a DCcEe Rh serological phenotype,positive for direct antiglobulin test and red cell elution.Based on the mother′s obstetric history,clinical manifestations of the infant and blood examination results,the diagnosis was HDN caused by anti-c antibodies.Conclusion For infants with HDN caused by anti-c antibodies in mother of Asian-type DEL,DCCee Rh phenotype red blood cell transfusion is recommended,while CCee Rh phenotype deglycerolized red blood cell transfusion is recommended for the mother.

关 键 词：抗-C 亚洲型DEL 输血 新生儿溶血 

分 类 号：R457.11[医药卫生—治疗学]