毛细管超速离心技术在Rh表型精准鉴定中的应用

Capillary ultracentrifugation technology in accurate identification of Rh phenotype

目的探讨毛细管超速离心技术在Rh表型精准鉴定以及临床输血中的应用。方法对本科室2019年5月~2020年2月血型鉴定结果中Rh表型呈混合外观的132例标本,使用毛细管超速离心技术进行分离后,分别取近心端和远心端红细胞进行Rh表型鉴定,然后选择与近心端Rh表型相同的献血者进行交叉配血。结果 132例标本经过毛细管超速离心后,128例(96.97%)标本近心端均能成功分离患者新生红细胞,精准鉴定出其Rh表型,检出CcDEe 47例(36.72%),CcDee 12例(9.38%),ccDEE 11例(8.59%),CCDee 52例(40.63%),ccDEe 5例(3.91%),ccDee 1例(0.78%);4例标本离心后Rh表型仍呈混合外观,此4例患者近2 d内均有输血史。128例精准鉴定出Rh表型的患者,均选择Rh表型同型献血者,4例未能确定Rh表型的患者,根据表型分布频率和减少抗原输注原则选择CCDee表型献血者,132例患者交叉配血均相合。结论毛细管超速离心技术能有效分离患者新生红细胞,辅助Rh表型的精准鉴定,为临床精准输血提供安全保障。

Objective To explore the application of capillary ultracentrifugation technology in accurate identification of Rh phenotype and clinical blood transfusion. Methods 132 samples, presenting mixed field agglutination during Rh phenotyping in our laboratory from May 2019 to February 2020, were separated using capillary ultracentrifugation technology, and the proximal and distal red blood cells were taken for Rh phenotype test, and then blood donors with the same Rh phenotype as the proximal cells were selected for cross matching.Results 132 samples were subjected to capillary ultracentrifugation, and new red blood cells were successfully isolated from the proximal side in 128(96.97%)cases, and the Rh phenotype was accurately identified, i.e. CcDEe in 47 cases(36.72%), CcDee in 12(9.38%). ccDEEin 11(8.59%), CCDee in 52(40.63%), ccDEe in 5(3.91%), and ccDee in 1(0.78%). 4 cases of mixed field reaction remained after centrifugation, and all of them had a history of blood transfusion within 2 days. For the 128 patients whose Rh phenotype was accurately identified, blood donors with the same type of Rh phenotype were selected, and 4 patients whose Rh phenotype could not be determined, donors with CCDee phenotype were selected based on the frequency of phenotype distribution and the principle of reducing antigen exposure. The cross-matched blood of all patients were consistent. Conclusion Capillary ultracentrifugation technology can effectively separate the new red blood cells, improve the accurate identification of Rh phenotype, and provide safety guarantee for clinical targeted blood transfusion.