意外抗体阳性患者Rh表型分布及Rh表型匹配输血效果

Distribution of Rh Phenotype in Whose Unexpected Antibodies Are Positive and Effect of Rh Phenotype Matching Transfusion

目的 探究意外抗体阳性患者Rh表型分布及Rh表型匹配输血效果。方法 回顾性收集平顶山市某综合性三级医院2018年3月至2022年3月收治的4 982例住院患者输血信息,其中106例意外抗体筛查阳性患者,对此患者血样行Rh抗原分型并进行意外抗体类别鉴定。统计106例患者意外抗体类别及Rh表型分布,评估其中39例Rh表型为CCDee且经Rh表型匹配输血患者的输血效果。结果 106例抗体筛查阳性患者,Rh表型主要为CCDee(74.53%),CcDEe、ccDEE、CcDee占比较小,ccDEe占比最小,仅1例(0.94%)。39例患者输血24 h后复查血常规,其中36例每输注2单位红细胞制品血红蛋白提高10 g·L^(-1)及以上,有效输血率为92.31%(36/39)。3例[7.69%(3/39)]患者发生溶血性输血不良反应。结论 意外抗体阳性患者中Rh血型系统的意外抗体占比最高,Rh表型中CCDee占比最高。Rh表型匹配输血效果较好。

Objective To explore the distribution of Rh phenotype in whose unexpected antibodies were positive and effect of Rh phenotype matching transfusion.Methods The blood transfusion information from 4982 hospitalized patients admitted to a comprehensive tertiary hospital in Pingdingshan from March 2018 to March 2022 were retrospectively collected.Among them,106 unexpected antibody screening positive patients,Rh antigen typing and unexpected antibody classification were performed on the patient’s blood sample.The types of unexpected antibodies and Rh phenotype distribution in 106 patients were calculated,and the transfusion efficacy of 39 patients with CCDee Rh phenotype and Rh phenotype matching transfusion was evaluated.Results Among 106 antibody screening positive patients,the Rh phenotype was mainly CCDee(74.53%),with a relatively small proportion of CcDEE,ccDEE,and CcDee.The proportion of ccDEe was the smallest,with only 1 case(0.94%).Among the 39 objects,a review of blood routine test at 24 hours after blood transfusion showed that in 36 patients,every 2 units of red blood cell transfusion led to at least 10 g·L^(-1) in hemoglobin,the patient response to blood transfusion was 92.31%(36/39).In these 39 patients,3 patients[7.69%(3/39)]developed hemolytic adverse reaction after Rh phenotype matched blood transfusion.Conclusion The proportion of Rh-blood-system unexpected antibodies is the highest.The proportion of CCDee in Rh phenotype is the highest.Rh phenotype matching blood transfusion effect is better.