Rh血型系统在安全输血中的意义

Significance of Rh Blood Group System in Safe Transfusion

目的研究配血不合患者血样中不规则抗体的分布特征,确定Rh血型系统在安全输血中的意义及输血策略。方法采用盐水介质法、聚凝胺试验、抗人球蛋白试验和木瓜酶试验对2007年1月～2008年12月来河北省血液中心申请疑难配血的153例患者血样进行血型鉴定、抗体筛查和特异性鉴定及交叉配血试验。结果153例受血者血液中,有134例存在不规则抗体,其中Rh系统免疫抗体68例(占50.75%),12例由多次妊娠免疫产生,55例由反复输血引起,1例为自身特异性;ABO和Rh以外其他血型系统抗体10例(占7.46%),单纯自身抗体阳性者56例(占41.79%)。结论在引起配血不合或溶血性输血反应的原因中,Rh系统的免疫居第1位,为受血者提供Rh因子同型血液输注是减少长期输血治疗患者发生Rh免疫的重要策略。

Objective To study the distribution of irregular antibodies in the serum samples positive in cross-matching test and confirm the significance of Rh blood group system in safe transfusion as well as blood transfusion strategy.Methods The serum samples positive in cross-matching test of 153 patients applying for blood matching from January 2007 to December 2008 were subjected to blood grouping,irregular antibody screening,identification of specificity and cross-matching test by saline medium method,polybrene test,Coombs test and papain test.Results A total of 134 samples were positive for irregular antibodies,of which 68（50.75%） for anti-Rh antibodies.The anti-Rh antibodies were induced by multiple pregnancy in 12 patients,by repeat blood transfusion in 55 patients,and was self-specific in one patient.Ten samples（7.46%）were positive for antibodies in blood group systems other than ABO and Rh systems,and 56（41.79%）for self antibodies.Conclusion Rh immunization is the prominent cause of cross-mismatching or haemolytic transfusion reaction.The transfusion with blood of the same Rh factors as those of donee is an important strategy to prevent Rh immunization in patients receiving long-term transfusion.