漳州地区孕妇Rh血型血清学分析与不规则抗体检测的临床意义

Clinical significance of Rh blood group serology and irregular antibody detection in pregnant women in Zhangzhou area

目的回顾并分析福建省漳州地区孕妇Rh血型血清学及红细胞不规则抗体检测结果,为建立和完善本地区产科安全输血和新生儿溶血病诊疗的临床资料提供实验依据。方法选择2020年1月1日—2022年12月31日在漳州市公立医院就诊的36496例孕妇作为研究对象,采用微柱凝胶法进行Rh血型抗原检测和不规则抗体筛查与鉴定,并对其结果进行统计学分析。结果36496例孕妇中,Rh(D)阳性36105例,阴性391例。检测出Rh血型系统的5种主要抗原的阳性率分别为D抗原98.93%,e抗原91.64%,C抗原87.12%,c抗原57.89%,E抗原48.22%。14种Rh血型表型阳性率从高至低排序前5位为DCCee(41.42%)、DCcEe(35.49%)、DCcee(8.94%)、DccEE(8.14%)、DccEe(3.71%);检出不规则抗体150例,其中二孩孕妇组检出率明显高于首次妊娠组(0.72%比0.03%,P<0.05),二孩孕妇组检出123例为Rh血型系统抗体,占比明显高于首次妊娠组(0.61%比0.02%,P<0.05)。结论做好二孩孕妇Rh血型表型检测和Rh血型抗体检测对指导产科科学用血,提高输血疗效和减少输血不良反应有重要意义,也可以作为二孩新生儿溶血病的预测、防范和救治的重要依据。

Objective To provide experimental evidence for the establishment and improvement of clinical data of obstetric safe blood transfusion and the diagnosis and treatment of neonatal hydrolysis in the local area,retrospect and analyze the Rh blood group serology and red blood cell irregular antibody detection in pregnant women in Zhangzhou,Fujian Province.Methods The 36496 pregnant women in public hospitals in Zhangzhou from January 1,2020 to December 31,2022 were selected as study objects.Using the microcolumn gel method,Rh blood group antigen detection and irregular antibody screening and identification were performed,and the results were statistically analyzed.Results Among the pregnant women,36105 cases were Rh(D)positive and 391 cases were negative.The positive rates of five main antigens of Rh blood group system were D antigen 98.93%,e antigen 91.64%,C antigen 87.12%,c antigen 57.89%,E antigen 48.22%.The top 5 of 14 types of Rh blood group phenotypes ranked by positive rate from high to low were DCCee(41.42%),DCcEe(35.49%),DCcee(8.94%),DccEE(8.14%),DccEe(3.71%).The 150 irregular antibodies were detected,among which the detectable rate of the second-child pregnancy group was obviously higher than that of first pregnancy group(0.72%vs.0.03%,P<0.05),and 123 cases of Rh blood group system antibodies were detected in second-child pregnancys group,which was higher than that in first pregnancy group(0.61%vs.0.02%,P<0.05).Conclusions It is important to do well in Rh blood group phenotype detection and Rh blood group antibody detection for second-child pregnant women,which has important significance in guiding obstetric scientific blood use,improving efficacy and reducing adverse transfusion reactions.It could also serve as an important basis for predicting,preventing and treating neonatal hemolytic disease for second-child newborns.