在抗体筛选阳性患者快速配血中应用Rh抗原分型的效果分析

Application of Rh antigen typing in rapid blood matching for irregular antibody positive recipients

目的探讨开展输血前对患者和献血者Rh血型抗原分型检测的有效性。方法 Rh抗原分型组:取2018年1月—2019年7月本院各临床用血科室及其他医院送检的抗体筛查阳性拟输血患者标本56例,采用微柱凝胶法对其和输血科库存97袋悬浮红细胞做Rh血型5种抗原(D、E、c、e、C)分型,再用盐水介质和抗球介质给二者做交叉配血;对照组:选择本院2017年1—12月临床各用血科室抗筛阳性、仅以盐水介质和抗球介质做交叉配血的25例输血患者与72袋库存红细胞。采用卡方检验比较2组交叉配血符合率。结果 Rh抗原分型组与未作Rh分型对照组配血相合率:92.8%(90/97)vs 12.5%(9/72)(P<0.05);平均配血时间(min):30.5±2.4 vs 51.4±4.1(P<0.05)。2组配血相合后输血有效。结论有条件的医院宜在输血前常规检测的基础上,对患者和库存血(献血者)Rh血型抗原做分型,有利于提高配血相合率,从源头上降低输血Rh血型不规则抗体发生率。

Objective To discuss the significance of Rh antigen typing in rapid blood matching for irregular antibody positive recipients of our hospital.Methods Rh antigen typing group: blood samples from 56 blood recipients with positive irregular antibodies, sent by other departments of our hospital even other hospitals during Jan. 2018 to Jul. 2019, were typed for 5 Rh antigens(D,E,c,e,C) using microcolumn gel method;meanwhile, the Rh antigen typing of 97 bags of suspended RBCs in stock were paralleled. Crossmatch between recipients and prospective donors were conducted using saline and antiglobulin tests. Control group: blind matching using saline and antiglobulin tests were conducted between 25 blood samples from recipients with positive irregular antibodies(Jan. to Dec. 2017) and 72 bags of suspended RBCs in stock.The rate of compatible crossmatch was compared between two groups via chi-square test.Results The rate of compatible cross matching in Rh-typing group was 92.8%(90/97), while 12.5%(9/72)in control group(P<0.05). It took Rh-typing group 30.5±2.4 minutes to finish crossmatch between recipients and donors, while control group 51.4±4.1 minutes(P<0.05). The blood transfusion of both groups were effective.Conclusion For recipients with positive irregular antibodies, Rh antigen typing of recipients and prospective donors before transfusion has superior efficiency in rapid blood matching compared to traditional blind-matching. It can minimize the risk of exposure to irregular antibodies and deserves further popularization.