临床输血中Rh表型检测及同型输注的必要性  

Detection of Rh phenotype in clinical blood transfusion and the necessity of homotype transfusion

作　　者：李晓芳 彭小友 王琼 何章勇[1] LI Xiaofang;PENG Xiaoyou;WANG Qiong;HE Zhangyong(Department of Blood Transfusion,First People’s Hospital of Chenzhou,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院输血科,湖南郴州423000

出　　处：《细胞与分子免疫学杂志》2024年第8期723-728,共6页Chinese Journal of Cellular and Molecular Immunology

基　　金：郴州市第一人民医院科研项目(N2019-048,2022KJ-080)。

摘　　要：目的探讨Rh表型检测及同型输血的重要性。方法采用微柱凝胶法对本院3411例反复输血患者与4735例献血员样本进行Rh表型(CcDEe)分型检测,对患者进行不规则抗体产生情况统计。对Rh同型输血组与随机输血组的输血效果进行统计学分析。结果本研究Rh抗原及其表型分布情况与已报道的结果相似,Rh CCDee、Rh CcDEe为高频表型,Rh血型系统的抗体为高频不规则抗体,占检出抗体的62.42%;随机输血组Rh系统不规则抗体产生率6.67%、直接抗人球蛋白试验阳性率10%均高于Rh同型输血组的0和3.3%,随机输血组发生输血不良反应3例,Rh同型输血组无输血不良反应发生,且该组输注红细胞后的血红蛋白上升更明显。结论在反复输血的患者中,Rh表型检测和同型输血,可避免随机输血造成的Rh血型鉴定和交叉配血困难,有效降低由Rh血型系统引起的输血免疫和输血不良反应的风险,提高输血疗效,确保临床输血安全。Objective To explore the importance of Rh phenotype detection and homotype blood transfusion.Methods The Rh phenotypes(CcDEe)of 3411 patients with repeated blood transfusions and 4735 blood donors were detected by the microcolumn gel test,and the positive rate of irregular antibodies was counted.A statistical analysis was conducted on the transfusion effectiveness between the Rh homotype transfusion group and the random transfusion group.Results The distribution of Rh antigen and its phenotype in our research is consistent with the reported results.Rh CCDee and Rh CcDEe are high-frequency phenotypes,and the antibodies of the Rh blood group system are high-frequency irregular antibodies,accounting for 62.42%of the detected antibodies.The positive rates of irregular antibodies in Rh system and direct antiglobulin test in random transfusion group were 6.67%and 10%,respectively,while those in Rh homotype transfusion group were 0%and 3.3%,respectively.There were three cases of adverse transfusion reactions in the random transfusion group,whereas no adverse transfusion reactions occurred in the Rh homotype transfusion group.The increase in hemoglobin was more significant after red blood cell transfusion in Rh homotype transfusion group.Conclusion In patients with repeated blood transfusions,Rh phenotype detection and the use of Rh homotype transfusion can avoid the difficulties associated with Rh blood group identification and cross-matching caused by random blood transfusions.It can effectively reduce the risk of immune and adverse reactions related to the Rh blood group system,improve the effectiveness of blood transfusion,and ensure the safety of clinical blood transfusions.

关 键 词：Rh表型 同型输注 临床安全输血 

分 类 号：R826.26[医药卫生—临床医学]