大量输血的地中血贫血患儿Rh血型抗体的分布及临床意义

Distribution of Rh blood group antibodies in thalassemia children with massive transfusion and its clinical significance

目的:研究大量输血的地中海贫血患儿外周血Rh血型抗体的检出率及其分布特点,分析Rh血型抗体的临床意义。方法:采用微柱凝胶抗球蛋白技术筛查和鉴定红细胞血型不规则抗体,对鉴定为Rh血型抗体者,采用单克隆抗-D、抗-C、抗-c、抗-E、抗-e鉴定红细胞Rh血型抗原,以确认抗体的准确性;检测抗体的效价、免疫球蛋白类型及37℃反应性,以明确其临床意义。结果:238例地贫患儿,检出Rh血型抗体11例,检出率为4.6%,抗体的特异性为:抗-E6例(54.5%)、抗-D3例(27.3%)、抗-cE1例(9.1%)、抗-C1例(9.1%);11例Rh血型抗体均为IgG或IgG加IgM,37℃均可与具有相应抗原的红细胞反应,抗体效价16～128。结论:地贫患儿Rh血型抗体的检出率显著高于普通人群;在检出的Rh血型抗体中,抗-E占绝对多数,并且抗体的产生与输血的次数相关。

Objective：To study the Rh blood group antibody detection rate and distribution characteristics in the peripheral blood of thalassemia children with massive transfusion, and analyze the clinical significance of Rh blood group antibodies and generating rules. Method：Screening of irregular red cell blood group antibodies were detected by the micro-column gel anti-globulin technique, the Rh blood group antibodies were identified using monoclonal anti-D, anti-C, anti-c, anti-E, anti-e and red cell Rh blood group antigen, to confirm the accuracy of antibody. Antibody titers, Ig types and 37 ℃ reactivity test were assayed to clarify its clinical significance.Result：A total of 238 thalassemia children cases were detected. Rh blood group antibodies were positive in 11 cases, which detection rate was 4.6%. The specificity of antibodies were 6 cases of anti-E （54.5%）, 3 of anti-D （27.3% ）, 1 of anti-cE （9.1%）, 1 of anti-C （9.1%）, and 11 cases of Rh blood group antibodies of IgG or IgG ＋ IgM class, which antibody titers were between 16 and 128.Conclusion：The detection rate of Rh blood group antibodies in thalassemia children was higher than that of general population. In the positive cases of the Rh blood group antibodies, anti-E accounted for an absolute majority, and the production of antibodies was positively correlated with the number of blood transfusion.