孕产妇血型同种抗体特征及RhCcEe配型输血分析
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摘要
目的探讨RhCcEe配型输血预防同种抗体的意义。方法回顾性分析2013年至2017年深圳市第二人民医院15 436例孕产妇同种抗体的筛选及鉴定结果,分析孕产妇同种抗体阳性率及其特异性分布、ABO血型以外新生儿溶血病的抗体特征,对比分析孕产妇RhCcEe配型输血与随机输血同种抗体阳性率、新生儿溶血病发生率。结果孕产妇血型同种抗体阳性率0.66%(102例),其中Rh血型占72.5%(74/102),MNSs血型占11.8%(12/102),Kidd血型占4.9%(5/102),Duffy血型占1.96%(2/102),Lewis血型占1.96%(2/102),Diego血型占0.98%(1/102),其他占5.88%(6/102)。在抗体阳性孕产妇中:2胎及以上孕产妇占75.5%,高于初胎孕产妇(25.4%);有输血史者占57.8%,高于无输血史者(42.2%);有妊娠史者占68.6%,高于无妊娠史者(31.4%)。ABO血型以外的新生儿溶血病25例,Rh血型占72%(18/25),MNSs 12%(3/25),Kidd 8%(2/25),其他8%(2/25);RhCcEe配型输血组同种抗体及新生儿溶血病发生率均低于随机输血组,差异有统计学意义(P<0.05)。结论孕产妇血型同种抗体发生率与生育史(或妊娠史)、输血史密切相关,Rh抗体阳性率占比最高;Rh血型抗原C、c、E、e同型输注可有效降低HDN发生,对预防孕产妇同种免疫具有一定的意义。
引文
[1]赵毓宏,白登科,邓永乐,等.临床Rh表型血清学检测及其同型输注必要性分析[J].临床检验杂志,2015,33(9):715-716.
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[8]伍昌林,王小华,何建安,等.长期输血的重型B地中海贫血患儿RH因子与临床输血有效性研究[J].中国实验血液学杂志,2015,23(6):1657-1661.
[9]Das S,Shastry S,Murugesan M,et al.What is it really anti-G or anti-D plus anti-C:clinical significance in antenatal Mothers?[J].Indian J Hematol Blood Transfus,2017,33(2):259-263.
[10]Sankaralingam P,Jain A,Bagga R,et al.Red cell alloimmunization in Rh D positive pregnant women and neonatal outcome[J].Transfus Apher Sci,2016,55(1):153-158.
[11]Yee MEM,Josephson CD,Winkler AM,et al.Red blood cell minor antigen mismatches during chronic transfusion therapy for sickle cell anemia[J].Transfusion,2017,57(11):2738-2746.
[2]de Haas M,Thurik FF,Koelewijn JM,et al.Haemolytic disease of the fetus and newborn[J].Vox Sang,2015,109(2):99-113.
[3]Karim F,Moiz B,Kamran N.Risk of maternal alloimmunization in Southern Pakistan-a study in a cohort of 1000 pregnant women[J].Transfus Apher Sci,2015,52(1):99-102.
[4]Bhuva DK,Vachhani JH.Red cell alloimmunization in repeatedly transfused patients[J].Asian J Transfus Sci,2017,11(2):115-120.
[5]Al-Dughaishi T,Al Harrasi Y,Al-Duhli M,et al.Red cell alloimmunization to rhesus antigen among pregnant women attending a tertiary care hospital in Oman[J].Oman Med J,2016,31(1):77-80.
[6]杨博,李肖甫.患儿过敏史对过敏性输血反应的影响[J].临床检验杂志,2018,36(3):227-228.
[7]Bollason G,Hjartardottir H,Jonsson T,et al.Red blood cell alloimmunization in pregnancy during the years 1996-2015 in Iceland:a nation-wide population study[J].Transfusion,2017,57(11):2578-2585.
[8]伍昌林,王小华,何建安,等.长期输血的重型B地中海贫血患儿RH因子与临床输血有效性研究[J].中国实验血液学杂志,2015,23(6):1657-1661.
[9]Das S,Shastry S,Murugesan M,et al.What is it really anti-G or anti-D plus anti-C:clinical significance in antenatal Mothers?[J].Indian J Hematol Blood Transfus,2017,33(2):259-263.
[10]Sankaralingam P,Jain A,Bagga R,et al.Red cell alloimmunization in Rh D positive pregnant women and neonatal outcome[J].Transfus Apher Sci,2016,55(1):153-158.
[11]Yee MEM,Josephson CD,Winkler AM,et al.Red blood cell minor antigen mismatches during chronic transfusion therapy for sickle cell anemia[J].Transfusion,2017,57(11):2738-2746.