上饶地区无偿献血者Rh血型分布调查与应用分析

Investigation and application analysis of Rh blood group distribution of unpaid blood donors in Shangrao area

目的研究RhD阳性献血者Rh表型分布频率,建立献血者Rh表型库并应用于患者疑难配血。方法10034例RhD阳性献血者,采用微量板盐水法检测献血者Rh(D)、Rh(C)、Rh(c)、Rh(E)、Rh(e)血型,分析RhD阳性献血者Rh表型ABO血型分布情况、Rh抗原分布情况以及不同Rh表型输血相容性频率,分析Rh血型不规则抗体阳性受血者情况。结果10034例RhD阳性献血者检出8种表型,占比由高到低为CCDee(46.98%)、CcDEe(33.84%)、CcDee(8.72%)、ccDEE(5.88%)、ccDEe(3.14%)、CCDEe(0.92%)、CcDEE(0.27%)、ccDee(0.25%),未检出CCDEE表型。RhD阳性献血者Rh抗原阳性率由高到低为e(93.85%)>C(90.73%)>c(52.10%)>E(44.05%)。根据本地区献血者Rh表型分布频率,应用表型相容性原理计算血液相容性频率,不同Rh表型输血相容性频率由高到低分别为CcDEe(100.00%)>CcDee(55.95%)>CCDEe(47.90%)>CCDee(46.98%)>ccDEe(9.27%)>CcDEE(6.15%)>ccDEE(5.88%)>ccDee(0.25%)>CCDEE(0)。从Rh表型库中调出与2例患者Rh表型一致的血样进行交叉配血,主侧在盐水、聚凝胺和抗人球蛋白介质中均未发生凝集及溶血现象,临床医院反馈患者红细胞计数明显升高,未发生输血不良反应。结论依据本地区Rh表型分布规律,科学合理的加强血液库存管理,为患者匹配Rh表型相容的血液,减少输血反应,提高输血安全性。

Objective To study the distribution frequency of Rh phenotypes in RhD positive blood donors,establish a Rh phenotype database of blood donors and apply them to patients with difficult blood matching.Methods 10034 cases of RhD-positive blood donors were tested by microplate saline method to detect Rh blood group of Rh(D),Rh(C),Rh(c),Rh(E)and Rh(e).Analysis was made on distribution of Rh phenotype ABO blood groups,Rh antigen distribution and the frequency of transfusion compatibility of different Rh phenotypes in RhD-positive blood donor,as well as the situation of recipients with irregular antibodypositive Rh blood groups.Results 8 phenotypes were detected in 10034 RhD-positive blood donors,with the highest to lowest percentages being CCDee(46.98%),CcDEe(33.84%),CcDee(8.72%),ccDEE(5.88%),ccDEe(3.14%),CCDEe(0.92%),CcDEE(0.27%),ccDee(0.25%),and no CCDEE phenotype was detected.The Rh antigen positivity rate in RhD positive donors from high to low was e(93.85%)>C(90.73%)>c(52.10%)>E(44.05%).According to the frequency of Rh phenotype distribution of blood donors in the region,the frequency of blood compatibility was calculated by applying the phenotypic compatibility principle,and the frequency of transfusion compatibility of different Rh phenotypes from high to low was CcDEe(100.00%)>CcDee(55.95%)>CCDEe(47.90%)>CCDee(46.98%)>ccDEe(9.27%)>CcDEE(6.15%)>ccDEE(5.88%)>ccDee(0.25%)>CCDEE(0).Blood samples consistent with the Rh phenotype of the two patients were transferred from the Rh phenotype bank for cross-matching.No agglutination and hemolysis occurred on the main side in saline,polyclotamine and anti-human globulin media,and the clinical hospital gave feedback that the patients'red blood cell counts were significantly higher and no adverse transfusion reactions occurred.Conclusion Blood inventory management should be strengthened scientifically and reasonably according to the distribution law of Rh phenotype in this region to match Rh phenotype compatible blood for patients,reduce blood transfusion reaction and improve blood transfusion safety.