六盘水地区不同民族住院患者红细胞血型及不规则抗体检测分析

Detection and Analysis of Red Blood Cell Blood Group and Irregular Antibody in Hospitalized Patients of Different Nationalities in Liupanshui Area

目的回顾性分析本地区不同民族患者红细胞血型、不规则抗体及其特异性分布情况,探究红细胞血型及不规则抗体分布在临床中的意义。方法选取2019年1月-2022年3月于我院进行ABO、RhD血型、RhCcEe抗原及不规则抗体检测的样本25270例,不规则抗体检测阳性者进行抗体鉴定,红细胞血型检测使用微柱凝胶法(单克隆抗体)检测,不规则抗体使用微柱凝胶抗人球蛋白法检测,对检测结果及其分布按ABO血型、RhD血型、Rh抗原表型(CcEe)、不规则抗体结果进行分类,分析不同民族、性别间的分布差异。结果25270例样本共有30个民族,男6961例,女18309例;ABO血型总体分布:O型9062例(35.86%)>A型7508例(29.71%)>B型6611例(26.16%)>AB型2089例(8.27%);汉族、彝族、穿青人、布依族、白族ABO血型分布依次为为O>A>B>AB,苗族为O>B>A>AB,回族为A>O>B>AB;彝、苗、回族ABO血型分布与汉族比较,差异有统计学意义(P<0.05);共检出RhD阴性111例(0.44%),回族占比最高(1.53%)、彝族占比最低(0.14%),与汉族比较,差异有统计学意义(P<0.05);Rh抗原表型(CcEe)总体分布:CCee>CcEe>Ccee>ccEE>ccEe>CCEe>ccee>CcEE>CCEE,不同民族Rh表型分布比较,差异有统计学意义(P<0.05);不规则抗体检出率为0.46%,其中白族0.80%,彝族0.64%,苗族0.52%,布依族0.38%,穿青人0.19%,各民族间不规则抗体检出率比较,差异有统计学意义(P<0.05);不同Rh表型不规则抗体检出率:CCee 0.57%,CcEe 0.28%,ccEE 0.41%,Ccee 0.36%,CCEe 0.68%,ccEe 0.46%,ccee 3.81%,不规则抗体检出率与Rh表型比较,差异有统计学意义(P<0.05)。结论六盘水地区红细胞ABO血型呈O>A>B>AB分布,不同民族ABO、RhD血型及Rh表型分布存在总体差异性;不规则抗体在不同Rh表型、不同民族中分布不同。血型分布情况对本地区中心血站采供计划、库存管理和血液调配具有重要意义,为少数民族红细胞血型遗传学数据提供参考依据;了解Rh表型及不规则抗体的频率及其差异性,可为不同民族制定输血策略、ABO、RhD以外抗原匹配性精准输血提供参考依据,对产前新生儿溶血诊疗具有重要临床意义。

Objective To retrospectively analyze the red blood cell blood group,irregular antibody and its specific distribution in patients with different nationalities in this region,and to explore the clinical significance of red blood cell blood group and irregular antibody distribution.Methods From January 2019 to March 2022,25270 samples were selected for ABO,RhD blood group,RhCcEe antigen and irregular antibody detection in our hospital.Those with positive irregular antibody detection were identified by antibody identification.Red blood cell blood group was detected by microcolumn gel method(monoclonal antibody),and irregular antibody was detected by microcolumn gel anti-human globulin method.The detection results and their distribution were classified according to ABO blood group,RhD blood group,Rh antigen phenotype(CcEe)and irregular antibody results,and the distribution differences among different nationalities and genders were analyzed.Results A total of 25270 samples were collected from 30 ethnic groups,including 6961 males and 18309 females.The overall distribution of ABO blood group:9062 cases of type O(35.86%)>7508 cases of type A(29.71%)>6611 cases of type B(26.16%)>2089 cases of type AB(8.27%).The distribution of ABO blood group in Han,Yi,Chuanqing,Buyi and Bai nationalities was type O>type A>type B>type AB,Miao was type O>type B>type A>type AB,Hui was type A>type O>type B>type AB.The distribution of ABO blood group in Yi,Miao and Hui nationalities was significantly different from that in Han nationality(P<0.05).A total of 111 cases(0.44%)of RhD negative were detected,with the highest proportion of Hui nationality(1.53%)and the lowest proportion of Yi nationality(0.14%),compared with Han nationality,the difference was statistically significant(P<0.05).The overall distribution of Rh antigen phenotype(CcEe):CCee>CcEe>Ccee>ccEE>ccEe>CCEe>ccee>CcEE>CCEE.The distribution of Rh phenotype in different ethnic groups was statistically significant(P<0.05).The detection rate of irregular antibody was 0.46%,including 0.80%of Bai nationality,0.64%of Yi nationality,0.52%of Miao nationality,0.38%of Buyi nationality and 0.19%of Chuanqing nationality.There was significant difference in the detection rate of irregular antibody among different nationalities(P<0.05).The detection rate of irregular antibodies in different Rh phenotypes:0.57%of CCee,0.28%of CcEe,0.41%of ccEE,0.36%of Ccee,0.68%of CCEe,0.46%of ccEe,3.81%of ccee.The detection rate of irregular antibodies was significantly different from that of Rh phenotype(P<0.05).Conclusion The distribution of red blood cell ABO blood group in Liupanshui area is type O>type A>type B>type AB,and there are overall differences in the distribution of ABO,RhD blood group and Rh phenotype among different ethnic groups.Irregular antibodies are distributed differently in different Rh phenotypes and different ethnic groups.The distribution of blood types is of great significance to the collection and supply plan,inventory management and blood allocation of the central blood stations in the region,and provides a reference for the genetic data of red blood cell blood types of ethnic minorities.Understanding the frequency and difference of Rh phenotype and irregular antibodies can provide a reference for different ethnic groups to develop blood transfusion strategies,ABO,RhD antigen matching precision blood transfusion,and has important clinical significance for prenatal neonatal hemolysis diagnosis and treatment.