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中国人输血产生RhCE同种抗体的风险和预防策略

Risk and prevention strategies for RhCE alloantibodies after blood transfusion in the Chinese population
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摘要 目的探索一种评估输血产生RhCE同种抗体风险的新途径,并制定选择RhCE相容供者的策略。方法根据兰德施泰纳法则和群体遗传学原理,确定在随机输血中供者与受者RhCE抗原错配的组合,根据中国人Rh血型分布大数据资料,计算错配组合的概率以及找到相容供者的机会。结果分析文献报告的458542例中国人RhD、C、c、E和e抗原分型资料,结果表明在只采用RhD同型输血的策略中,RhCE抗原错配占全部输血的25.16%,其中Rh表型DCCee、DccEE、DCcee和DccEe错配分别占比14.97%、5.01%、2.21%和2.26%,表型Dccee、DCCEE、DCCEe和DCcEE错配合计占比0.71%。Rh表型DCcEe个体可以接受任何Rh表型供者的血液。结论中国人Rh血型以高频率DCe单倍型为特征,Rh表型DCCee个体是随机输血后产生RhCE同种抗体的高风险群体。RhC、c、E和e抗原分型对寻找Rh抗原匹配供者有重要意义。使用常见RhCE表型相容供者的输血,可以预防大约90%的受者产生RhCE同种抗体。 Objective To explore a new approach to assess the risk of RhCE alloantibodies after transfusion and to establish a strategy for selecting RhCE compatible donors.[WTHX]Methods The Landsteiner’s law and the principle of population genetics were used to determine the combinations of RhCE antigen mismatch between donor and recipient in random blood transfusion,and the big data of Rh blood group distribution in the Chinese population were used to calculate mismatch probability and the chance of finding compatible donors.[WTHX]Results An analysis was performed for the data of RhD,C,c,E,and e antigen typing for 458542 Chinese individuals reported in the literature,and the results showed that in the strategy of only using RhD matched donors,RhCE antigen mismatches accounted for 25.16%of all blood transfusions,among which the mismatch of Rh phenotypes DCCee,DccEE,DCcee,and DccEe accounted for 14.97%,5.01%,2.21%,and 2.26%,respectively,and the mismatch of the phenotypes Dccee,DCCEE,DCCEe,and DCcEE accounted for 0.71%in total.The individuals with DCcEe phenotype could accept the blood from a donor with any Rh phenotype.[WTHX]Conclusion The Rh blood group in the Chinese population is characterized by a high frequency of DCe haplotype,and individuals with Rh phenotype DCCee are the high-risk population for producing RhCE alloantibodies after blood transfusion.RhC,c,E,and e antigen typing is of great significance in searching for Rh antigen matched donors.Blood transfusion from donors compatible with common RhCE phenotypes can prevent the appearance of RhCE alloantibodies in approximately 90%of recipients.
作者 赵桐茂 ZHAO Tongmao(National Institutes of Health,Bethesda 20892,USA)
出处 《精准医学杂志》 2024年第6期482-485,490,共5页 Journal of Precision Medicine
关键词 精准输血 兰德施泰纳法则 RH血型系统 RhCE抗原匹配 输血反应 血型抗原 同种抗体 群体遗传学 中国人 Precise transfusion Landsteiner’s law Rh blood group RhCE antigen matching Transfusion reaction Blood group antigen Alloantibody Population genetics Chinese
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