RhC抗原在输血后24h对孕产妇免疫功能的影响

Effect of Rh C antigen on immune function of pregnant women within 24 hours after blood transfusion

目的：通过检测Rh C抗原对孕产妇免疫功能的影响,倡导更加安全、合理输血的方法。方法：通过对急诊手术患者的Rh C血型进行检测（患者要求为无输血史和其他免疫病史的孕妇,年龄在18-40岁之间）。根据其Rh C的结果进行分组,并选择配血结果相合的,输注Rh C不同型的血液组为实验组,输注Rh C同型的血液组为对照组。分别应用ELISA法测定白细胞介素-2（IL-2）、白细胞介素-4（IL-4）的变化,应用流式细胞术测定CD3＋、CD4^＋、CD8^＋的变化规律。结果：实验组IL-2水平输血前高于输血后、IL-4水平输血前低于输血后,差异有统计学意义（P〈0.01）;对照组IL-2、IL-4水平输血前、输血后比较,差异无统计学意义（P〉0.05）。实验组CD3^＋、CD4^＋、CD8^＋阳性细胞输血前高于输血后,差异具有统计学意义（P〈0.05）,对照组CD3＋、CD4^＋、CD8^＋阳性细胞输血前、输血后比较,差异无统计学意义（P〉0.05）。结论：Rh C抗原非同型输注会对孕产妇的免疫功能造成一定的影响,因此Rh C抗原同型输注的是十分必要的,我国应根据实际国情,适当调整《临床输血技术规范》中的相关要求,从而减少免疫性输血反应、特别是对新生儿溶血病的预防和治疗有重要意义,提高临床输血安全性。

Objective： To explore the effect of Rh C antigen on immune function of pregnant women,advocate a more safe and reasonable blood transfusion method. Methods： Rh C blood types of the pregnant women aged 18- 40 years old（ without blood transfusion history and history of other immune diseases） receiving emergency surgery were detected,then the pregnant women were divided into experimental group（ Rh C antigen infusion of the same type） and control group（ Rh C antigen infusion of different type）. ELISA was used to detect the changes of interleukin- 2（ IL- 2） and interleukin- 4（ IL- 4）; flow cytometry was used to detect the change regularity of CD3^＋,CD4^＋and CD8^＋. Results： In experimental group,IL- 2 level before blood transfusion was higher than that after blood transfusion,while IL- 4level before blood transfusion was lower than that after blood transfusion,there were statistically significant differences（ P〈0. 01）; in control group,there was no statistically significant difference in IL- 2 and IL- 4 levels between before and after blood transfusion（ P〉0. 05）.In experimental group,the positive rates of CD3^＋,CD4^＋and CD8^＋cells before blood transfusion was statistically significantly higher than that after blood transfusion（ P〈0. 05）; in control group,there was no statistically significant difference in the positive rates of CD3^＋,CD4^＋and CD8^＋cells between before and after blood transfusion（ P〉0. 05）. Conclusion： Rh C antigen infusion of different type has a certain impact on immune function of pregnant women,thus Rh C antigen infusion of the same type is very necessary; targeting to the actual situation in China,the related requirements of Technical Specifications of Clinical Blood Transfusion should be adjusted reasonably to reduce immune blood transfusion reaction,especially for prevention and treatment of neonatal hemolytic diseases,it has important significance,so the safety of clinical blood transfusion is improved.