抗-D抗体产生人群Rh分型与输血安全探讨

Exploration on the Transfusion Safety and Rh Grouping Feature Among Population with Anti-D Alloantibody

目的探讨产生红细胞同种抗-D抗体的Rh阴性湖北汉族人群Rh分型分布特征及输血安全。方法对968例确认为Rh阴性的人群进行抗体鉴定,对检出红细胞同种抗-D抗体的人群进行Rh分型,并分析其接受Rh阴性或Rh阳性含红细胞血制品输注时产生其他抗-Rh抗体的产生风险。结果在确认为Rh阴性的968例人群中检出红细胞同种抗-D抗体103例,其抗-D抗体发生率为10.4%;在产生抗-D抗体人群检出ccee和Ccee两种Rh分型,以ccee为最常见,约为79.7%(82/103);该人群接受Rh阴性或Rh阳性血制品输注导致抗-Rh类抗体产生风险最高分别为17.93%、33.89%;该人群接受Rh分型不一致血制品输注所产生的抗-Rh类抗体主要为抗-C。结论产生红细胞同种抗-D抗体的Rh阴性人群接受Rh分型不一致血制品输注时有产生红细胞同种抗体的风险;在有条件且非紧急情况下,该人群可接受Rh分型一致的血制品输注。

Objective To explore the transfusion safety and distribution characteristics of Rh grouping among Rh negative Han popu- lation with anti -D alloantibody in Hubei. Methods We identified the alloantibody of 968 Han population individuals whose Rh group was confirmed negative, then detected the erythrocyte Rh phenotype. We analyzed the risk of other anti - Rh alloantibody formation by re- ceiving Rh negative or positive red blood cell transfusions at last. Results Totally 103 anti - D alloantibodies were identified in the above 968 indivivuals and the incidence of anti - D alloantibody production was 10.4%. The ccee and Ccee Rh phenotype were detected in the 103 patient with anti - D alloantibody and the ccee Rh phenotype took the highest incident rate of 79.7% （82/103）. For the risk of anti -Rh alloantibody production, the highest risks were 17.93% and 33.89% when transfusion with Rh negative or positive erythrocyte blood products, respectively. The most common anti - Rh was anti - C alloantibody. Conclusion It is risky to transfuse red cell products with different Rh phenotype in Rh negative population, which gives the risk of red cell alloantibody production which discussed in this pa- per. The Rh negative population could receive erythrocyte products with identical Rh phenotype if the condition permits in non - urgent