208例RhD初筛阴性孕产妇Rh表型及意外抗体分析  

An Analysis of Rh Phenotype and Unexpected Antibodies in 208 RhD Negative Pregnant Patients

作　　者：张文丽 李萍[2] 宗朋 陈增生[1] ZHANG Wenli;LI Ping;ZONG Peng;CHEN Zengsheng(Department of Clinical Laboratory,Qingdao Municipal hospital,Qingdao 266000,China;Department of Transfusion,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛市市立医院检验科,山东青岛266000 [2]青岛大学附属医院输血科,山东青岛266000

出　　处：《标记免疫分析与临床》2025年第1期100-103,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的 分析我院RhD初筛阴性孕产妇Rh表型的分布特点和意外抗体产生的频率,为临床安全输血及新生儿溶血病(HDN)的预防提供保障。方法 对2019年1月至2022年12月我院手术备血或产前血型鉴定的孕产妇进行Rh分型检测、意外抗体筛选及鉴定;HDN的检测包括直接抗人球蛋白试验、游离抗体试验和抗体释放试验。结果 共有40 079例孕产妇进行Rh分型检测,初筛RhD阴性208例,阴性比率为0.52%(208/40 079),其中A型57例,B型72例,O型68例,AB型11例;208例RhD初筛阴性表型中,ccdee 123例,Ccdee 62例,ccdEe 12例,CCdee 6例,CcdEe 2例,3例RhD确认实验结果为D变异型,其表型为ccEe2例,Ccee 1例;意外抗体阳性11例,阳性率为5.29%(11/208),其中抗-D 8例,表型分别为Ccdee 1例,ccdee 4例,CCdee 1例,ccdEe 1例,ccEe D变异1例;抗-D+抗-C 1例,其表型为ccdEe;抗-Mur 1例;抗体无特异性1例;11例意外抗体阳性中只有1例抗-D发生了HDN。C抗原阳性和E抗原阳性表型产生抗-D抗体的比例有明显差异(P<0.05)。结论 我院RhD阴性孕产妇表型以ccdee为主,其次是Ccdee、ccdEe、CCdee、CcdEe,意外抗体以抗-D最为常见,以E抗原阳性者比例最高。Objective To analyze the distribution characteristics of Rh phenotype and the frequency of unexpected antibodies production of pregnant women with negative RhD screening results in our hospital, so as to provide a better guarantee for the safety of clinical blood transfusion and prevention of Hemolytic Disease of Newborn(HDN).Methods Rh typing testing and accidental antibody screening were performed in pregnant and postpartum women who underwent surgical blood preparation or prenatal blood type identification in our hospital from January, 2019 to December, 2022;The detection methods of hemolytic disease of newborn included direct anti-human globulin test, free antibody test, and antibody release test. Results A total of 40 079 patients were tested for Rh typing. Of these, 208 were RhD-negative at first screening, and the negative rate was 0.52%(208/40 079). Among them, 57 were type A, 72 were type B, 68 were type O, and 11 were type AB. Of the 208 RhD initial screening negative phenotypes, 123 cases were ccdee, 62 cases were Ccdee, 12 cases were ccdEe, 6 cases were CCdee, 2 cases were CcdEe, the other 3 cases were D variants, including 2 ccEe cases and 1 Ccee case. Among the 208 cases, 11 were unexpected antibody positive, and the positive rate was 5.29%(11/208), of which 8 cases were anti-D, and their Rh phnotype were Ccdee 1, ccdee 4, CCdee 1, ccdEe 1, respectively, and 1 was ccEe D variants;One case had anti-C+D and its phenotype was ccdEe;One case had anti-Mur;One case had non-specificity. Among these 11 cases, only 1 case of anti-D developed HDN. There was a significant difference in the proportion of anti-D antibodies produced by the C antigen positive and E antigen positive phenotypes(P<0.05).Conclusion The phenotype of RhD negative patients in our hospital is mainly ccdee, followed by Ccdee, ccdEe, CCdee, and CcdEe. Anti-D is the most common type of unexpected antibody, and the highest proportion is E-positive.

关 键 词：RHD阴性 Rh表型 意外抗体 D变异型 孕产妇 

分 类 号：R457.11[医药卫生—治疗学]