RhCcEe抗原配合性输血在β-地中海贫血患者血液输注中的应用
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摘要
目的研究RhCcEe抗原配合性血液输注在β-地中海贫血患者血液输注中的应用。方法将本院β-地中海贫血需长期输注红细胞的患者随机分为实验组和对照组,实验组实验组进行ABO,Rh C、c、D、E、e抗原相合性或相容性输血,对照组仅进行ABO、RhD相合性输血。观察2组研究对象不规则抗体产生及输血不良反应发生情况。结果本地区RhCcEe表型分布与其他地区相吻合。实验组不规则抗体阳性率为0,远低于对照组的10.41%(P<0.05)。2组输血不良反应发生率差距有统计学意义(P<0.05):实验组输血不良反应发生率为0;而对照组有2例发生迟发性血清学反应,2例发生迟发性溶血性输血反应及1例非溶血性发热输血不良反应发生。结论 RhCcEe配合性血液输注可降低β-地中海贫血患者输血后的不规则抗体产生率及输血不良反应发生率,应大范围推广。
Objective To study the application of RhCcEe compatibility management in blood transfusion of patients with β-thalassaemia.Methods The patients with thalassemia requiring long-term transfusion of erythrocytes were randomly divided into experimental group and control group. ABO, Rh C, c, D, E and e antigen compatible transfusion was performed in the experimental group, and only ABO and RhD antigen compatible transfusion was performed in the control group. Results The RhCcEe phenotype distribution in this region was consistent with that in other regions.The rate of irregular antibody positivity in the experimental group was 0, which was much lower than that in the control group(10.41%, P<0.05). No adverse reactions were observed in the experimental group. However, in the control group, 2 cases had failed erythrocyte transfusion, 2 cases had delayed hemolytic transfusion reaction and 1 case had non-hemolytic fever transfusion adverse reaction.Conclusion RhCcEe compatibility management is helpful to reduce the rate of irregular antibody production and the incidence of adverse reactions after transfusion in patients with thalassemia. It should be widely promoted.
Objective To study the application of RhCcEe compatibility management in blood transfusion of patients with β-thalassaemia.Methods The patients with thalassemia requiring long-term transfusion of erythrocytes were randomly divided into experimental group and control group. ABO, Rh C, c, D, E and e antigen compatible transfusion was performed in the experimental group, and only ABO and RhD antigen compatible transfusion was performed in the control group. Results The RhCcEe phenotype distribution in this region was consistent with that in other regions.The rate of irregular antibody positivity in the experimental group was 0, which was much lower than that in the control group(10.41%, P<0.05). No adverse reactions were observed in the experimental group. However, in the control group, 2 cases had failed erythrocyte transfusion, 2 cases had delayed hemolytic transfusion reaction and 1 case had non-hemolytic fever transfusion adverse reaction.Conclusion RhCcEe compatibility management is helpful to reduce the rate of irregular antibody production and the incidence of adverse reactions after transfusion in patients with thalassemia. It should be widely promoted.
引文
[1] 何文,王晓东,余海燕.妊娠合并地中海贫血研究现状.中华妇幼临床医学杂志,2017,13(1):14-18.
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[3] 李雪英,李志平,王敏,等.孕妇IgG血型抗体与新生儿溶血病的关系.实用儿科临床杂志,2011,26(17):1376.
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[16] Cheng CK,Lee CK,Lin CK.Clinically significant red blood cell antibodies in chronically transfused patients:a survey of Chinese thalassemia major patients and literature review.Transfusion,2012,52(10):2220-2224.
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[19] 黄皑,冯卫民,张毅华,等.重型β-地贫儿童血清不规则抗体筛查与鉴定分析.中国优生与遗传学杂志,2012,20(2):123-125.
[20] 李岚,翁彬,孟庆宝.重型β-地中海贫血患者突变基因及同种血型抗体频率调查.中国输血杂志,2016,29(3):284-286.
[21] 徐朴,李艳,余华.湖北汉族RhD 阳性健康人群Rh 分型特征调查分析.临床血液学杂志,2014,27(8):689.
[22] 邵智利,韩利霞,马德冉,等.Rh血型系统相容性输血在儿科中的应用探讨.中国输血杂志,2017,30(30):281-284.
[23] 张青梅,周金安.Rh系统抗体检出率与妊娠次数的关系探讨.临床血液学杂志,2012,15(2):782-783.
[24] 曹国平,罗云丁,婧韦颖,等.234 例不规则抗体性质分类与临床输血对策.中国输血杂志,2015,28(7):809-811.
[25] 王明泉,高晶晶,谢仁伟,等.长期输血重型β-地中海贫血患儿不规则抗体产生及其与RH 因子和贫血基因突变位点的相关性分析.中国实验血液学杂志,2017,25(6):1756 - 1760.
[26] Shenoy S,Angelucci E,Arnold SD,et al.Current results and future research priorities in late effects after hematopoietic stem cell transplantation for children with sickle cell disease and thalassemia:a consensus statement from the Second Pediatric Blood and Marrow Transplant Consortium International Conference on Late Effects after Pediatric Hematopoietic Stem Cell Transplantation.Biol Blood Marrow Transplant,2017,23(4):552-561.
[2] 韦海春,郑敏.重型β地中海贫血的输血治疗研究进展.中国当代医药,2018,25 (26):31-34.
[3] 李雪英,李志平,王敏,等.孕妇IgG血型抗体与新生儿溶血病的关系.实用儿科临床杂志,2011,26(17):1376.
[4] 金皎.自身免疫性溶血性贫血研究进展.实用儿科临床杂志,2010,25(15):1127.
[5] 马荣国,夏和凤,金勇.献血者抗-E致配血不合1例.中国输血杂志,2012,25(1):70-71.
[6] 周根水,童小燕,舒锦.Rh非D型新生儿溶血病11例.中国输血杂志,2009,22(6):496.
[7] 张青梅,周金安.Rh系统抗体检出率与妊娠次数的关系探讨.临床血液学杂志,2012,15(12):782-783.
[8] 文永,徐艳.地中海贫血患儿输血与Rh 血型的选择.现代医药卫生,2018,34 (2):242-244.
[9] Cappelini M-D,Cohen A,Eleftheriou A,et al.Guidelines for the clinical management of thalassaemia.2th ed.Nicosia Cyprus:Thalassaemia International Federation,2008:23-27.
[10] Marina CC,Emmanuel P,Olivier N,et al.Transfusion independence and HMGA2 activation after gene therapy of humanβ-thalassaemia.Nature,2010,467(7313):318-322.
[11] 徐湘民.地中海贫血预防控制操作指南.北京:人民军医出版社,2011:48-52.
[12] 党鑫堂,伍昌林,王学东,等.定期输血地中海贫血患者血清抗体检测.中国输血杂志,2017,30(10):1135-1136.
[13] Matteocci A,Pierelli L.Red blood cell alloimmunization in sickle cell disease and in thalassaemia:current status,future perspectives and potential role of molecular typing.Vox Sang,2014,106(3):197-208.
[14] Kosaryan M,Mahdavi M R,Roshan P,et al.Prevalence of alloimmunisation in patients with beta thalassaemia major.Blood Transfus,2012,10(3):396-397.
[15] Azarkeivan A,Ansari S,Ahmadi MH,et al.Blood transfusion and alloimmunization in patients with thalassemia:multicenter study.Pediatr Hematol Oncol,2011,28(6) :479-485.
[16] Cheng CK,Lee CK,Lin CK.Clinically significant red blood cell antibodies in chronically transfused patients:a survey of Chinese thalassemia major patients and literature review.Transfusion,2012,52(10):2220-2224.
[17] Chao YH,Wu KH,Lu JJ,et al.Red blood cell alloimmunisation among Chinese patients withβ-thalassaemia major in Taiwan.Blood Transfus,2013,11(1):71-74.
[18] 伍昌林,朱奕,党鑫堂,等.大量输血的地中海贫血患儿Rh血型抗体研究及临床意义.临床血液学杂志,2012,25(6):363-364.
[19] 黄皑,冯卫民,张毅华,等.重型β-地贫儿童血清不规则抗体筛查与鉴定分析.中国优生与遗传学杂志,2012,20(2):123-125.
[20] 李岚,翁彬,孟庆宝.重型β-地中海贫血患者突变基因及同种血型抗体频率调查.中国输血杂志,2016,29(3):284-286.
[21] 徐朴,李艳,余华.湖北汉族RhD 阳性健康人群Rh 分型特征调查分析.临床血液学杂志,2014,27(8):689.
[22] 邵智利,韩利霞,马德冉,等.Rh血型系统相容性输血在儿科中的应用探讨.中国输血杂志,2017,30(30):281-284.
[23] 张青梅,周金安.Rh系统抗体检出率与妊娠次数的关系探讨.临床血液学杂志,2012,15(2):782-783.
[24] 曹国平,罗云丁,婧韦颖,等.234 例不规则抗体性质分类与临床输血对策.中国输血杂志,2015,28(7):809-811.
[25] 王明泉,高晶晶,谢仁伟,等.长期输血重型β-地中海贫血患儿不规则抗体产生及其与RH 因子和贫血基因突变位点的相关性分析.中国实验血液学杂志,2017,25(6):1756 - 1760.
[26] Shenoy S,Angelucci E,Arnold SD,et al.Current results and future research priorities in late effects after hematopoietic stem cell transplantation for children with sickle cell disease and thalassemia:a consensus statement from the Second Pediatric Blood and Marrow Transplant Consortium International Conference on Late Effects after Pediatric Hematopoietic Stem Cell Transplantation.Biol Blood Marrow Transplant,2017,23(4):552-561.