献血者Rh(D)阴性DEL表型调查研究

Investigation on DEL phenotype in blood donors with negative Rh(D)

目的通过对Rh(D)阴性献血者的试验检测,了解DEL表型。方法用盐水法、木瓜酶法3家试剂检测RhD(-)及其RhCcDE 4个因子;阴性者用谱细胞进行抗体筛查;红细胞用抗-D作吸收放散试验,观察试验结果;吸收前、后抗-D抗体检测其效价。结果无偿献血者16935例,其中Rh(D)阴性75例,占4.42%;吸收放散试验:75例经吸收放散试验检测,阳性标本47例、占62.67%,阴性28例;吸收前、后抗体效价比较:吸收后抗体效价不变的53例,效价下降的有22例。结论在鉴定Rh(D)阴性中,DEL表型应用血型血清学吸收放散的方法正确鉴定;在临床输血中,含有弱D与DEL的个体,反复多次输血后就有产生抗体的可能。含有弱D与DEL的个体,作为供者应该当成阳性,作为受者应该当成阴性,防止因输血产生免疫性抗体,引起输血反应。

Objective To investigate the DEL pbenotype distribution by testing the blood donors with negative Rb（D）. Methods Normal saline and papain methods were employed with 3 kinds of reagents to determine the negative Rb（D） and other 4 RbCeDE factors. Antibody screening was employed with spectrum cells in those negative ones. The erythrocytes were tested by absorption and irradiation test with anti-D and the results were observed. The titer of the anti-D antibody was observed before and after absorption. Results Among all the 16935 volunteer blood donors, those with negative Rh（D） occupied 4.42%（75 cases）. All the 75 cases were tested by absorption and irradiation test with 47 positive （62.67%） and 28 negative cases. During the comparison of the antibody titers before and after the absorption, the antibody titers remained unchanged after the absorption in 53 cases and decreased in 22 cases. ConcLusion In those blood donors with negative Rh（D）, DEL phenotype could be correctly identified by blood group serology and absorption and irradiation. During the clinical blood transfusion, repeats and multiple blood transfusion could lead to the production of the antibody in those with individual weak D and DEL phenotype. This suggests that those individuals with weak D and DEL phenotype can be identified as positive when they served as donors and as negative when as receivers, so as to prevent the production of immunological antibody due to blood transfusion and to prevent blood transfusion reaction.