孕产妇Rh表型分布特征及相容性输血的可行性探讨  

Distribution Characteristics of Rh Phenotype and Feasibility of Compatible Blood Transfusion in Pregnant and Postpartum Women

作　　者：杨桂林 张涛[1] 李春莉[1] 张宏鹏[1] 吴盈盈 李胜蓝 万块 杨赟平[1] YANG Gui-Lin;ZHANG Tao;LI Chun-Li;ZHANG Hong-Peng;WU Ying-Ying;LI Sheng-Lan;WAN Kuai;YANG Yun-Ping(Department of Blood Transfusion,Women and Children's Hospital of Chongqing Medical University,Chongqing Health Center for Women and Children,Chongqing 401147,China)

机构地区：[1]重庆医科大学附属妇女儿童医院,重庆市妇幼保健院输血科,重庆401147

出　　处：《中国实验血液学杂志》2024年第3期868-874,共7页Journal of Experimental Hematology

基　　金：重庆市科卫联合医学科研项目(2019MSXM043)。

摘　　要：目的:分析重庆地区孕产妇Rh表型分布特征,探讨Rh表型在孕产妇中的临床意义及实行Rh表型相容性输血的可行性。方法:采用微柱凝胶法对65161例孕产妇进行ABO血型和Rh表型检测,以同期48122例男性为对照,通过χ^(2)检验对数据进行比较分析。结果:113283例样本中,RhD+112870例(99.64%),以CCDee(48.39%)和Cc DEe(32.88%)为主要表型,并检出重庆地区首例Rh缺失型D--表型;Rh D-413例(0.36%),以ccdee(52.78%)和Ccdee(33.41%)为主要表型;RhD+组与Rh D-组的Rh表型分布差异有统计学意义(P<0.01)。在65161例孕产妇中,Rh5种抗原的阳性率由高到低为D>e>C>c>E,与男性相比差异无统计学意义(P>0.05);孕产妇Rh表型分布与男性相比差异无统计学意义(P>0.05);不同ABO血型的孕产妇间Rh表型分布差异无统计学意义(P>0.05)。在孕产妇中,正常妊娠人群、有不良流产史人群、采用人类辅助生殖技术人群和不孕症患者人群间Rh表型分布无明显差异(P>0.05),4个孕产妇人群与本地区综合性三甲医院住院患者和献血者相比,Rh表型分布差异无统计学意义(P>0.05)。RhD阳性孕产妇中,CcDEe表型找到相容性血液的概率为100%,CCDee、CcDee和CCDEe表型找到相容血液的概率为45%-60%,ccDEE、ccDEe、CcDEE表型找到相容血液的概率为5%-10%,其余表型的相容概率均低于0.5%;提供CCDee和ccDEE两个表型的血液即可满足99%以上患者7种Rh表型相容性输血需求。结论:应对孕产妇进行Rh表型检测,对需要输血的孕产妇推行Rh表型相同或相容性输血是切实可行的输血举措。Objective:To analyze the distribution characteristics of Rh phenotype in pregnant and postpartum women in Chongqing area,and to explore the clinical significance of Rh phenotype in pregnant and postpartum women and the feasibility of Rh phenotype compatible blood transfusion.Methods:The ABO blood group and Rh phenotype of 65161 pregnant and postpartum women were detected by microcolumn gel method,and 48122 males in the same period were taken as controls.The data were analyzed by Chi-square test.Results:There were 112870 cases(99.64%)of RhD+in 113283 samples.In RhD+cases,CCDee(48.39%)and CcDEe(32.88%)were the main phenotypes.The first case of D--phenotype in Chongqing area was detected.413 cases(0.36%)of RhD-were detected,with ccdee(52.78%)and Ccdee(33.41%)as the main phenotypes.Compared with RhD-group,RhD+group showed statistically significant difference in Rh phenotype distribution(P<0.01).Among 65161 maternal samples,the positive rate of 5 antigens of Rh blood group from high to low was D>e>C>c>E,and there was no significant difference compared with male samples(P>0.05).There was no significant difference in the distribution of Rh phenotype between males and pregnant/postpartum women,as well as between pregnant/postpartum women with different ABO blood groups(P>0.05).In pregnant and postpartum women,there was no significant difference in distribution of Rh phenotype among the normal pregnancy population,the population with adverse pregnancy history,the population using human assisted reproductive technology(ART)and the population with infertility(P>0.05).There was no significant difference in the distribution of Rh phenotype between the 4 populations mentioned above and the inpatients in the local general Grade A hospitals and the blood donors(P>0.05).In RhD positive pregnant and postpartum women,the probability of finding compatible blood for CcDEe phenotype was 100%,the probability of finding compatible blood for CCDee,CcDee and CCDEe phenotypes was 45%-60%,the probability of finding compatible blood for ccDE

关 键 词：孕产妇 Rh表型 Rh缺失型D-- Rh血型相容性输血 

分 类 号：R457.1[医药卫生—治疗学]