摘要
目的探讨Rh血型相容性输血在孕产妇输血中的应用效果。方法回顾性选取2020年8月至2023年12月在河南省人民医院接受输血的560例孕产妇进行研究,按输血方式不同分组,其中280例实施ABO抗原和RhD抗原相合性输血者纳入A组,280例实施ABO抗原和RhD、C、c、E、e血型相容性输血者纳入B组。观察全部患者的C、c、E、e抗原分布及表型分布,比较两组患者的不规则抗体阳性率及类型分布、输血后红细胞压积(HCT)及血红蛋白(Hb)变化。结果560例患者血液样本中RhD(+)524例(93.57%),RhD(-)36例(6.43%),其中RhD(+)患者中以e抗原占比最高,RhD(-)患者中以E抗原占比最高;RhD(+)患者有10种表型,分别为CCDee、CcDEe、CcDee、ccDEE、cc DEe、CCDEe、CcDEE、ccDee、CCDEE、--D--,其中以CCDee(47.90%)表型占比最高,RhD(-)患者有5种表型,分别为CCdee、CcdEe、Ccdee、ccdEe、ccdee,其中以ccdee(52.78%)表型占比最高;A组患者的不规则抗体阳性率为21.43%(60/280),明显高于B组的9.64%(27/280),差异有显著统计学意义(P<0.01),A组患者不规则抗体阳性类型有7种,分别为抗-D、抗-C、抗-c、抗-E、抗-e、抗-Ce、抗-Ec,以抗-E(26.67%)占比最高,B组患者不规则抗体阳性类型有6种,分别为抗-D、抗-C、抗-c、抗-E、抗-e、抗-Ce,以抗-E(37.04%)占比最高;输血后,B组患者的HCT、Hb分别为(33.18±5.86)%、(110.65±26.84)g/L,明显高于A组的(30.25±5.10)%、(103.69±25.69)g/L,差异均有统计学意义(P<0.05)。结论Rh血型相容性输血在孕产妇输血中的应用能降低患者的不规则抗体发生率,改善孕产妇的血液状况,减少输血不良反应。
Objective To investigate the efficacy of Rh blood group compatibility transfusion in maternal trans-fusion.Methods A retrospective analysis was conducted on 560 pregnant women who received blood transfusions at Henan Provincial People’s Hospital from August 2020 to December 2023.They were divided into two groups based on transfusion methods:group A(n=280)received ABO and Rh D antigen-matched transfusion,while group B(n=280)re-ceived ABO and Rh D,C,c,E,e antigen-compatible transfusion.The distribution of C,c,E,e antigens and phenotypes was observed.The positive rate and types of irregular antibodies,as well as changes in hematocrit(HCT)and hemoglo-bin(Hb)levels post-transfusion,were compared between the two groups.Results Among the 560 blood samples,524(93.57%)were RhD(+)and 36(6.43%)were RhD(-).In RhD(+)patients,the e antigen was the most prevalent,where-as in RhD(-)patients,the E antigen was dominant.Ten phenotypes were identified in RhD(+)patients:CCDee,CcDEe,CcDee,ccDEE,ccDEe,CCDEe,CcDEE,ccDee,CCDEE,and--D--,with CCDee(47.90%)being the most common.RhD(-)patients exhibited five phenotypes:CCdee,CcdEe,Ccdee,ccdEe,and ccdee,with ccdee(52.78%)being pre-dominant.The irregular antibody positivity rate in group A(21.43%,60/280)was significantly higher than that(9.64%,27/280)in group B(P<0.01).Group A had seven types of irregular antibodies(anti-D,anti-C,anti-c,anti-E,anti-e,an-ti-Ce,anti-Ec),with anti-E(26.67%)being the most frequent.Group B had six types(anti-D,anti-C,anti-c,anti-E,an-ti-e,anti-Ce),with anti-E(37.04%)as the most common.After transfusion,group B showed significantly higher HCT and Hb compared to group A:(33.18±5.86)%vs(30.25±5.10)%;(110.65±26.84 g/L)vs(103.69±25.69)g/L,P<0.05.Conclusion Rh blood group compatibility transfusion in maternal patients reduces the incidence of irregular antibod-ies,improves hematological parameters,and minimizes transfusion-related adverse reactions.
作者
郑帅奎
郑晓彩
赵言腾
李占伟
燕备战
ZHENG Shuai-kui;ZHENG Xiao-cai;ZHAO Yan-teng;LI Zhan-wei;YAN Bei-zhan(Department of Blood Transfusion,Henan Provincial People's Hospital,Zhengzhou 450000,Henan,CHINA;Department of Gastroenterology and Hemorrhoids and Fistula,Jiaxian People's Hospital,Pingdingshan 467100,Henan,CHINA;Department of Blood Transfusion,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,CHINA;Department of Blood Transfusion,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,CHINA)
出处
《海南医学》
2025年第13期1914-1917,共4页
Hainan Medical Journal
基金
河南省科技攻关计划项目(编号:232102310028)。
关键词
Rh血型相容性输血
不规则抗体
孕产妇
输血反应
Rh blood group compatibility transfusion
Irregular antibodies
Pregnant women
Transfusion reac-tion
