rh血型抗体的检测及结果分析

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1、Rh血型抗体的检测及结果分析作者：吴远军,吴勇,陈宝婵,刘艳【摘要】　　目的:调查Rh血型抗体的检出率及其特异性分布特点,分析Rh血型抗体的临床意义及产生规律。方法:采用微柱凝胶抗球蛋白技术筛查和鉴定红细胞血型不规则抗体,对鉴定为Rh血型抗体者,采用单克隆抗D、抗C、抗c、抗E、抗e鉴定红细胞Rh血型抗原,以确认抗体的准确性;检测抗体的效价、Ig类型及37℃反应性,以明确其临床意义;询问孕产史、输血史,如果为新生儿检测其母亲血浆中是否有相同特异性的抗体,以分析抗体产生的原因。结果:就诊者54000例,共检出Rh血型抗体47例,检出率为0.087%,其中有妊娠史者27例,有

2、输血史者13例,既有妊娠史又有输血史者1例,抗体来自母体的新生儿6例;抗体的特异性为:抗E29例(61.70%)、抗D8例(17.02%)、抗cE5例(10.64%)、抗c4例(8.51%)、抗C1例(2.13%);47例Rh血型抗体均为IgG或IgG+IgM类,37℃均可与具有相应抗原的红细胞反应,抗体效价介于1～4096。结论:被检就诊者Rh血型抗体的检出率低于白种人;在检出的Rh血型抗体中,抗E占绝对多数,而抗D的检出率呈逐步减少的趋势;妊娠和输血引起的同种免疫是Rh血型抗体产生的原因,新生儿自母体被动获得的Rh血型抗体是NonABOHDN最主要的致病抗体。

3、【关键词】Rh血型不规则抗体免疫溶血性输血反应12新生儿溶血病微柱凝胶抗球蛋白试验　　[Abstract]AIM:TostudytheprevalenceanddistributionofantiRhbloodgroupantibodiesinChinesepopulationanditsclinicalsignificance.METHODS:IrregularantibodieswerescreenedandidentifiedbyMicrocolumGelCoomb’stest.ForthoseidentifiedaspositiveantiRhsamples,monoc

4、lonalantibodies(antiD,C,c,Eande)wereusedtoidentifythespecificantigenandconfirmtheaccuracyoftheirregularantibodytests.Thetiters,Igtypesand37℃reactivityweretestedtoconfirmitsclinicalsiginificance.Forevaluationoftheoriginofirregularantibodies,historiesofpregnancyandtransfusionwerereviewed.

5、Forthenewbornswhohadpositiveantibodies,theirmothersweretestedsimultaneouslytoconfirmtheoriginoftheantibodies.RESULTS:47outof54000(0.087%)patientswereidentifiedaspositivewithRhbloodgroupantibodies.Ofthem,27caseshadhistoryofpregnancy,13hadtransfusionand1hadthehistoriesofboth.6newbornshadantibodi

6、esderivedformtheirmothers.Thespecificityoftheantibodywasasfollows:29withantiE(61.70%),8withantiD(17.02%),anticE5(10.64%),4withantic(8.51%)and1withantiC(2.13%).Allthe47Rhblood12groupantibodieswereIgGorIgG+IgM,andwerereactivetoredbloodcellswithcorrespondingantigensat37℃,withahighesttiterof1

7、∶4096.CONCLUSION:TheprevalenceofRhantibodiesislowerinChinesepopulationascomparedwiththatinWhitepopulation.Ofalltheantibodies,antiEismostfrequentlyidentifiedandantiDwasdeclining.Alloimmunizationbypregnancyandtransfusionisthemajorcausof