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临床输血与检验 ›› 2021, Vol. 23 ›› Issue (3): 310-314.DOI: 10.3969/j.issn.1671-2587.2021.03.005

• 临床输血 • 上一篇    下一篇

西安地区供受血者红细胞Rh表型匹配输注及追踪分析

权军辉, 张明刚, 邵香, 左旭盈   

  1. 710004 陕西西安,西安交通大学第二附属医院输血科(权军辉,张明刚,左旭盈); 陕西省中医院脾胃一病区(邵香)
  • 收稿日期:2020-07-18 出版日期:2021-06-20 发布日期:2021-06-22
  • 作者简介:权军辉(1987-),男,主管技师,本科,主要从事临床输血相关研究,(E-mail)815746613@qq.com。

Rh Phenotype Distribution and Red Blood Cells Antigen Matching for Transfusion in Blood Donors and Recipients in Xi'an

QUAN Jun-hui, ZHANG Ming-gang, SHAO Xiang, et al   

  1. Department of Blood Transfusion, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004
  • Received:2020-07-18 Online:2021-06-20 Published:2021-06-22

摘要: 目的 研究受血者Rh表型分布特征,并探索其红细胞(red blood cell,RBC)配合规律。方法 Aigel 300检测并传输1 117例受血者ABO血型、Rh表型、抗筛及3 174例供血者Rh表型,TMIS9.5接收并实现供受双方Rh表型Ⅰ、Ⅱ、Ⅲ级匹配。输注RBC后15日开始对受血者做为期6个月抗筛追踪,并运用SPSS 25.0做风险评估。结果 西安地区供受血者RBC匹配输注结局:受血者Ⅲ级输注概率17.82%,供血者Ⅲ级匹配概率8.99%;918例Ⅰ+Ⅱ级(匹配输注)受血者,输注前有8例抗筛阳性;199例Ⅲ级受血者,输注前有1例抗筛阳性。半年后追踪到Ⅰ+Ⅱ级受血者448例,新增1例抗筛阳性(为非Rh系统抗体);Ⅲ级受血者91例,新增4例抗筛阳性(均为Rh系统抗体)。Rh表型Ⅲ级RBC输注风险显著[χ2=5.586,P<0.05;OR=9.103 ,95%CI=(1.003,82.633)];Ⅰ+Ⅱ级不显著[χ+2=0.191,P+>0.05;OR+=1.284,95%CI+=(0.418,3.947)]。结论 西安地区供受血者Rh表型分布符合人群基本特征;建议有生育需求(女性)、免疫功能正常患者避免输血,必须输注时应遵循Ⅰ+Ⅱ级Rh表型匹配或依次避开E、c、C、e、D中风险最大抗原。

关键词: 受血者, 供血者, Rh表型, 匹配输注

Abstract: Objective To study the Rh phenotype distribution among blood recipients, and to determine crossmatch compatibility rules of their red blood cells (RBCs). Methods Aigel 300 was used to detect and transmit ABO blood type, Rh phenotype, irregular antibody screening for 1 117 blood recipients, and Rh phenotype for 3 174 blood donors. TMIS9.5 was used to receive and crossmatch the Rh phenotypes for both the donor and the recipient. On the 15th day after transfusion, blood recipients would be followed up for 6 months, and SPSS 25.0 was used for risk assessment. Results Outcomes of donor- recipient matched RBC transfusions in Xi'an area: The probability of transfusion level Ⅲ for recipients was 17.82%, and the probability of matching level Ⅲ for donors was 8.99%. In 918 patients with grade Ⅰ+Ⅱ (matched transfusion), 8 of which had positive screening antibodies before transfusion; One out of 199 patients with grade Ⅲ had a positive screening antibody before transfusion. Six months later, 448 recipients with grade Ⅰ+Ⅱ were traced, and one new case was a positive screening antibody (non-Rh antibody); Among 91 recipients with grade Ⅲ, 4 new cases were anti-screening antibodies (all anti-Rh antibodies). The risk of RBCs transfusion with Rh phenotype grade Ⅲ was significant [χ2=5.586,P<0.05;OR=9.103 ,95%CI=(1.003,82.633)]; while, that of grade Ⅰ+Ⅱ was not significant[χ+2=0.191,P+>0.05;OR+=1.284,95%CI+=(0.418,3.947)]. Conclusion The distribution of donor-recipient Rh phenotype in Xi'an area accorded with the basic demographic characteristics. It is recommended that patients with fertility needs and normal immune function avoid blood transfusion. When transfusion is necessary, they should follow the matched Rh phenotype grade Ⅰ+Ⅱ or avoid the most risky antigens among E, c, C, e and D in sequence.

Key words: Blood recipient, Blood donor, Rh phenotype, Matched infusion

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