邯郸地区住院患者Rh表型分布研究

Study on distribution of Rh phenotype among hospitalized patients in Handan area

目的:分析邯郸地区住院患者Rh表型分布特点,并探讨其对临床输血的价值。方法:通过对邯郸地区某医院2021年1月—2023年7月13 892例患者Rh表型分型结果进行分析,分析Rh表型ABO血型分布情况、Rh抗原分布情况、Rh表型不同性别分布情况及Rh抗原表现型和基因型是否符合Hardy-Weinberg平衡定律。结果:(1)Rh表型分型情况:13 892例住院患者中相同Rh表型在不同ABO血型之间差异无统计学意义(χ^(2)=39.75,P>0.05);不同性别患者间的Rh表型分布频率差异无统计学意义(χ^(2)=6.549,P>0.05)。Rh表型在RhD阳性和阴性住院患者中分布差异有统计学意义(χ^(2)=4 526.157,P<0.05)。(2)Rh抗原分布情况:RhD阳性患者Rh抗原分布趋势为e(91.99%)>C(87.75%)>c(59.54%)>E(50.15%);RhD阴性患者Rh抗原分布趋势为e(41.94%)>c(40.86%)>C(11.83%)>E(5.38%)。(3)Rh表型基因频率:RhD阳性组合体频率CDe(0.622 4)>cDE(0.282 7)>cDe(0.020 1)>CDE(0.003 8),RhD阴性组合体频率cde(0.054 0)>Cde(0.011 5)>cdE(0.004 8)>CdE(0.000 7),基因频率C=0.638 4、c=0.361 6、D=0.923 8、d=0.076 2、E=0.292 0、e=0.708 0,观察值与期望值的差异无统计学意义,符合Hardy-Weinberg吻合度分布规律。结论:依据邯郸地区Rh血型系统抗原表型分布特点,优先采取Rh同型或相容性方案,当库存无法满足时可根据产生不规则抗体的概率选择相应血液成分。因此科学合理地为患者匹配相应的血液,为临床实现精准输血提供依据。

Objective: To analyze the distribution characteristics of Rh phenotype among hospitalized patients in Handan area, and explore its value for clinical blood transfusion. Methods: The distribution of Rh phenotype in different ABO blood types, Rh antigen distribution, Rh phenotype distribution by gender, and whether Rh antigen phenotype and genotype comply with Hardy Weinberg's equilibrium law were analyzed respectively by investigating the Rh phenotype results of 13 892 patients in a hospital in Handan area from January 2021 to July 2023. Results:(1)The status of Rh phenotype: There was no statistically significant difference in the same Rh phenotype among different ABO blood types among 13 892 hospitalized patients(χ^(2)=39.75, P>0.05). There was no statistically significant difference in Rh phenotype distribution frequency between patients of different genders(χ^(2)=6.549, P>0.05). There was a statistically significant difference in the distribution of Rh phenotype between RhD positive and negative inpatients(χ^(2)=4 526.157, P<0.05).(2)Rh antigen distribution: The proportion of Rh antigens in RhD positive patients, from high to low, was e(91.99%), C(87.75%), c(59.54%) and E(50.15%). The proportion of RhD negative patients, from high to low, was e(41.94%), c(40.86%), C(11.83%) and E(5.38%).(3)Rh phenotype gene frequency: The frequencies of RhD positive combinations were CDe(0.622 4)>cDE(0.282 7)>cDe(0.020 1), respectively. The frequencies of RhD negative combination were cde(0.054 0)>Cde(0.011 5)>cdE(0.004 8)>CdE(0.000 7), respectively. Gene frequency were C=0.638 4, c=0.361 6, D=0.923 8, d=0.076 2, E=0.292 0, e=0.708 0, and there was no statistically significant difference between the observed value and the expected value, which was consistent with the Hardy Weinberg distribution pattern of fit. Conclusion: Based on the distribution pattern of Rh phenotype in the local area, the Rh isotype or compatibility protocol was preferred. When the blood stocks could not be satisfied, the corresponding blood component could be selected according to the probability of producing irregular antibodies. Matching Rh phenotype compatible blood for patients could provide a basis for precise blood transfusion in clinical practice scientifically and reasonably.