Rh分型在献血者和输血者中的分布情况及同型输血的临床意义

Distribution of Rh typing in blood donors and blood recipients and clinical significance of homotypic blood transfusion

目的:分析Rh分型在献血者和输血者中的分布情况及同型输血的临床意义。方法:回顾性分析2020年1月至2022年12月该院收治的8024例输血患者的临床资料,按照是否实施Rh分型同型输血将输血患者分为对照组(未实施Rh分型同型输血即Rh随机配合性输血)3968例和观察组(实施Rh分型同型输血即献血者与受血者Rh分型一致或献血者Rh抗原少于受血者)4056例。另收集同期河南省驻马店市中心血站的4222份RhD阳性无偿献血者的血液样本进行研究。均行ABO和RhD血型鉴定、红细胞血型系统不规则抗体筛查和红细胞Rh血型抗原特异性鉴定,统计并分析Rh分型在献血者和输血者中的分布情况、输血者不规则抗体产生概率及Rh分型同型输血的临床意义。结果:A、B、O、AB 4种血型的献血者和输血者共检出8种Rh分型,其中以CCDee、CcDEe为主;观察组输血后不规则抗体产生概率低于对照组,差异有统计学意义(P<0.05)。结论:献血者和输血者Rh分型均以CCDee、CcDEe为主,实施Rh分型同型输血可避免不规则抗体的产生。

Objective:To analyze distribution of Rh typing in blood donors and blood recipients and clinical significance of homotypic blood transfusion.Methods:The clinical data of 8024 patients with blood transfusion admitted to this hospital from January 2020 to December 2022 were retrospectively analyzed.According to whether or not to implement Rh typing homotypic blood transfusion,these patients were divided into control group(3968 cases without Rh typing homotypic blood transfusion,that is,Rh random matching cooperative transfusion)and observation group(4056 cases with Rh typing homotypic blood transfusion,that is,the Rh typing of blood donors and blood recipients is consistent or the Rh antigen of blood donors is less than that of blood recipients).In addition,4222 blood samples of RhD positive voluntary blood donors from the central blood station of Zhumadian city,Henan province during the same period were collected for the study.ABO and RhD blood type identification were performed.The irregular antibody screening of red blood cell blood group system and specific identification of red blood cell Rh blood group antigen were performed.The distribution of Rh typing in blood donors and blood recipients,the probability of irregular antibody production in the blood recipients and the clinical significance of Rh typing homotypic blood transfusion were statistically analyzed.Results:8 Rh types were detected in the blood donors and blood recipients of 4 blood types A,B,O and AB,among which CCDee and CcDEe were the main types.The probability of irregular antibody production after blood transfusion in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:CCDee and CcDEe are the main Rh typing of blood donors and blood recipients.Rh typing homotypic blood transfusion can avoid the production of irregular antibodies.