您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报 (医学版) ›› 2022, Vol. 60 ›› Issue (7): 98-103.doi: 10.6040/j.issn.1671-7554.0.2021.1454

• 临床医学 • 上一篇    下一篇

山东省济南市RhD阴性无偿献血者表型分布调查及不规则抗体筛查的临床意义

周娜1,2,潘英芳1,邵静茹1,李京1,宋永红1,徐群1,吕红娟1   

  1. 1.山东省血液中心血型参比研究室, 山东 济南 250014;2.山东大学齐鲁医学院, 山东 济南 250012
  • 发布日期:2022-07-27
  • 通讯作者: 吕红娟. E-mail:Luhongjuan@163.com
  • 基金资助:
    山东省血液中心站内课题(2020ky05);山东省医药卫生科技发展项目(2019WS543,2019WS539,202011000741)

Clinical significance of Rh phenotype distribution and irregular antibody screening in RhD negative blood donors in Jinan of Shandong Province

ZHOU Na1,2, PAN Yingfang1, SHAO Jingru1, LI Jing1, SONG Yonghong1, XU Qun1, LYU Hongjuan1   

  1. 1. Blood Group Reference Laboratory, Shandong Blood Center, Jinan 250014, Shandong, China;
    2. Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China
  • Published:2022-07-27

PDF (PC)

85

摘要： 目的 调查统计山东省济南市RhD阴性无偿献血者的Rh表型分布及不规则抗体筛查情况,为促进合理采集、供应RhD阴性稀有血液提供数据支持。 方法 收集山东省血液中心2020年7月至2021年6月期间初筛为RhD阴性的血液样本,进行不规则抗体筛查及Rh表型确认。 结果 877例初筛为RhD阴性的无偿献血者中,确认D变异型55例,RhD阴性822例;RhD阴性献血者检出抗筛阳性6例,占比0.73%;检出的抗体包括4例抗D抗体,1例抗M抗体,1例抗Lea抗体;RhD阴性献血者中女性抗筛阳性率远高于男性。 结论 本地区RhD阴性献血者中女性抗筛阳性率远高于男性,抗体产生的原因多为妊娠和天然因素;RhD阴性稀有血型献血者进行Rh抗原表型检测和不规则抗体筛查,对于临床安全输血工作意义重大,有助于RhD阴性血液的科学合理采集。

关键词: RhD阴性, Rh表型, 不规则抗体, 无偿献血者, 稀有血型库

Abstract: Objective To investigate the phenotype distribution and irregular antibody screening of RhD negative blood donors in Jinan, Shandong Province, so as to provide data support for rational collection and supply of RhD negative blood. Methods Blood samples of RhD negative blood donors were collected from Shandong Blood Center from July 2020 to June 2021 and then irregular antibody screening and Rh phenotype confirmation were conducted. Results Among the 877 RhD negative blood donors who were initially confirmed, 55 cases were RhD variants blood donors, and 822 were confirmed RhD negative blood donors by three kind of anti-D reagents, 6(0.730%)of which were irregular antibody positive. Antibodies detected included 4 anti-D antibodies, 1 anti-M antibody and 1 anti-Lea antibody. Positive rate of irregular antibody was much higher in female RhD negative blood donors than that in male. Conclusion Positive rate of irregular antibody in female RhD negative blood donors is much higher than that in male and the causes of antibody production are mostly natural and immune antibodies by pregnancy. Rh antigen phenotype detection and screening of irregular antibody for RhD negative blood donors are helpful for scientific and rational collection of RhD negative blood, which is of great significance for the clinical safety of blood transfusion.

Key words: RhD negative, Rh antigen phenotype, Irregular antibody, Blood donors, Rare blood database

中图分类号: 

  • R446
[1] Makroo RN, Rajput S, Agarwal S, et al. Prevalence of irregular red cell antibody in healthy blood donors attending a tertiary care hospital in North India [J]. Asian J Transf Sci, 2018, 12(1): 17-20.
[2] Nasr IH, Mcintosh AP, Hussain K, et al. Preoperative cross-matching in major head and neck surgery: a study of a department's current practice and eligibility for electronic cross-matching [J]. Oral Surg Oral Med O, 2013, 116(5): 534-539.
[3] Wang YJ, Liu JR, Liu Y. Safety issues related to the electronic cross-matching of blood in mainland China: a prospective cohort study involving cross-matching of 40,228 blood samples [J]. Medicine, 2019, 98(35): e16703.
[4] Chung HJ, Hur M, Sang GC, et al. Benefits of VISION Max automated cross-matching in comparison with manual cross-matching: a multidimensional analysis [J]. PLoS One, 2019, 14(12): e0226477.
[5] 蔡茵, 曹斌, 周喆, 等. 上海地区无偿献血者血液中不规则抗体的调查[J]. 中国输血杂志, 2017, 30(7): 791-793. CAI Yin, CAO Bin, ZHOU Zhe, et al. Investigation of irregular antibodies in blood samples from donors in Shanghai area [J]. Chinese Journal of Blood Transfusion, 2017, 30(7): 791-793.
[6] 胡梅京, 车丽敏, 张艳宾, 等. 探讨ABO, RhD血型调查与建立Rh表型库在安全输血中的临床意义[J]. 河北医科大学学报, 2020, 41(6): 5. HU Meijing, CHE Limin, ZHANG Yanbin, et al. To explore the clinical significance of ABO, Rh blood type investigation and establishment of Rh phenotype library in safe blood transfusion [J]. Journal of Hebei Medical University, 2020, 41(6): 5.
[7] 于天华, 遇红梅, 梁海英, 等. 5050名患者Rh分型及不规则抗体鉴定结果分析[J]. 中国输血杂志, 2012, 25(8): 756-758.
[8] Liu Y, Lv Y, Xu D, et al. The necessity of clinical Rh phenotypic serological detection and homotypic infusion in patients with repeated blood transfusion [J]. Med Sci Monit, 2020, 26. doi:10.12659/MSM.921058.
[9] 刘慧, 张华, 童笑梅. 非免疫性胎儿水肿新生儿的临床特征及预后分析[J]. 中国当代儿科杂志, 2019, 21(3): 253-258. LIU Hui, ZHANG Hua, TONG Xiaomei. Clinical features and prognosis of neonates with nonimmune hydrops fetalis [J]. Chinese Journal of Contemporary Pediatrics, 2019, 21(3): 253-258.
[10] 孙波, 孙小媛, 邵长峰, 等. 青岛市部分患者与献血者人群Rh表型及单体型频率分布特征分析[J]. 中国输血杂志, 2021, 34(3): 205-207. SUN Bo, SUN Xiaoyuan, SHAO Changfeng, et al. The distribution characteristics of Rh phenotype and haplotype frequency in Qingdao: an analysis based on some patients and local blood donors [J]. Chinese Journal of Blood Transfusion, 2021, 34(3): 205-207.
[11] 刘丽丽, 马艳梅, 黄占华, 等. RhD阴性无偿献血者抗原表型及抗体筛查情况调查[J]. 北京医学, 2021, 43(6): 560-563.
[12] 胡艳. 健康献血者红细胞血型不规则抗体筛选在临床输血中的意义[J]. 中国医药指南, 2020, 18(16): 94-95. HU Yan. The Significance of screening irregular antibody to red blood group of healthy blood donors in clinical blood transfusion [J]. Guide of China Medicine, 2020, 18(16): 94-95.
[13] 徐宁, 张勇萍, 杨世明, 等. 献血员直接抗球蛋白试验及不规则抗体阳性引起交叉配血不合的分析[J]. 细胞与分子免疫学杂志, 2018, 34(1): 75-77.
[14] 何红红, 汤龙海, 陆荣, 等. 苏州市RhD阴性献血者血型抗原及表型分布研究[J]. 临床血液学杂志, 2019, 32(6): 4. HE Honghong, TANG Longhai, LU Rong, et al. Distribution of phenotype and blood type antigen in RhD negative blood donors in Suzhou [J]. Journal of Clinical Hematology, 2019, 32(6): 4.
[15] 张爱, 林洪铿, 何觅, 等. 福州地区献血人群Rh血型分布特征的调查分析[J]. 福建医药杂志, 2020, 42(2): 3. ZHANG Ai, LIN Hongkeng, HE Mi, et al. Investigation of Rh phenotypes in Fuzhou blood donors [J]. Fujian Medical Journal, 2020, 42(2): 3.
[16] 聂婷婷, 杨帆, 韩瑜, 等. 221例初筛RhD阴性个体中D变异型分析[J]. 中国实验诊断学, 2021, 25(9): 1372-1373.
[17] 高朋真. RhD阴性献血者1412例表型分布特征和不规则抗体[J]. 河南医学研究, 2021, 30(3): 414-417. GAO Pengzhen. Phenotypic distribution characteristics and irregular antibody in 1412 RhD negative blood donors [J]. Henan Medical Research, 2021, 30(3): 414-417.
[18] 权军辉, 张明刚, 邵香, 等. 西安地区供受血者红细胞Rh表型匹配输注及追踪分析[J].临床输血与检验, 2021, 23(3): 310-314. QUAN Junhui, ZHANG Minggang, SHAO Xiang, et al. Rh phenotype distribution and red blood cells antigen matching for transfusion in blood donors and recipients in Xian [J]. Journal of Clinical Transfusion and Laboratory Medicine, 2021, 23(3): 310-314.
[19] 阳志勇, 陈芝喜. Rh抗原分型检测对反复输血患者的临床意义[J]. 中国免疫学杂志, 2018, 34(2): 267-269. YANG Zhiyong, CHEN Zhixi. Clinical significance of Rh antigen typing detection for patients who require blood transfusions repeatedly [J]. Chinese Journal of Immunology, 2018, 34(2): 267-269.
[20] 郭伟, 徐群, 邵超鹏. 304例Rh阴性孕产妇的RhD同种免疫分析[J]. 山东大学学报(医学版), 2010, 48(11): 94-97. GUO Wei, XU Qun, SHAO Chaopeng. RhD isoimmunization analysis of 304 RhD-negative pregnant and lying-in women [J]. Journal of Shandong University(Health Sciences), 2010, 48(11): 94-97.
[21] 马玲, 刘衍春, 吴敏慧, 等. RhD阴性孕妇产前意外抗体筛查回顾性分析[J]. 临床检验杂志, 2020, 38(1): 34-36.
[22] 章昊, 苏宇清, 周华友, 等. 32例孕产妇IgG型不规则抗体的分析[J]. 中国输血杂志, 2018, 31(8): 828-831. ZHANG Hao, SU Yuqing, ZHOU Huayou, et al. Analysis of the irregular antibodies detected in 32 pregnant women [J]. Chinese Journal of Blood Transfusion, 2018, 31(8): 828-831.
[23] 严洁婷, 丁梦圆, 许学明, 等. 抗-M抗体检测方式及临床意义研究[J]. 交通医学, 2021, 35(4): 4.
[24] 周娜, 李柯成, 李京, 等. 济南地区肿瘤患者血型不规则抗体分布特点[J]. 山东医药, 2020, 60(15): 85-88.
[25] 洪小珍, 许先国, 朱发明, 等. 血清学和分子生物学鉴定Lewis血型抗体引起的输血反应[J]. 中国实验血液学杂志, 2008, 16(5): 4. HONG Xiaozhen, XU Xianguo, ZHU Faming, et al. Identification of the hemolytic transfusion reaction caused by Lewis antibody using serological and molecular biological methods [J]. Journal of Experimental Hematology, 2008, 16(5): 4.
[26] 强新晨, 杨华莹, 邵俊良. 孕产妇Rh抗原表型分布及其在Rh新生儿溶血病预防中价值探讨[J]. 中国实验诊断学, 2021, 25(5): 702-705. QIANG Xinchen, YANG Huaying, SHAO Junliang, et al. Rh antigen phenotype distribution in pregnant women and its value in prevention of Rh neonatal hemolytic disease [J]. Chinese Journal of Laboratory Diagnosis, 2021, 25(5): 702-705.
[27] 杨秀华, 杨惠宽, 黄建云, 等.不规则抗体筛查分布及其临床意义[J]. 中国输血杂志, 2014, 27(9): 899-902. YANG Xiuhua, YANG Huikuan, HUANG Jianyun, et al. Distribution of irregular antibodies and clinical significance [J]. Chinese Journal of Blood Transfusion, 2014, 27(9): 899-902.
[28] Thongbut J, Raud L, Férec C, et al. Comprehensive molecular analysis of serologically D-negative and weak/partial D phenotype in Thai blood donors [J]. Transfus Med Hemoth, 2019, 47(1): 1-7.
[29] Banseok K, Seung-Tae L, Sinyoung K, et al. Application of multiplex ligation-dependent probe amplification assay for genotyping major blood group systems including Del variants in the D-negative Korean population [J]. Ann Lab Med, 2018, 38(1): 32-38.
[30] Ogasawara K, Suzuki Y, Sasaki K, et al. Molecular basis for D Japanese: identification of novel DEL and D alleles [J]. Vox Sang, 2015, 109(4): 359-365.
[31] Chen DP, Sun CF, Ning HC, et al. Comprehensive analysis of RHD splicing transcripts reveals the molecular basis for the weak anti-D reactivity of Del-red blood cells [J]. Transfus Med, 2016, 26(2): 123-129.
[32] 郭萍莉. 无偿献血者不规则抗体分布及输血安全分析[J]. 山西医药杂志, 2020, 49(11): 1333-1335. GUO Pingli. Irregular antibody distribution and blood transfusion safety in unpaid blood donors [J]. Shanxi Medical Journal, 2020, 49(11): 1333-1335.
[33] 冯娜, 左琴琴, 张雅莉, 等. 献血者含不规则抗体血液的处置及临床应用研究[J]. 中国输血杂志, 2021, 34(2): 182-185. FENG Na, ZUO Qinqin, ZHANG Yali, et al. The processing of blood with irregular antibodies and its clinical application [J]. Chinese Journal of Blood Transfusion, 2021, 34(2): 182-185.
[1] 樊瑞军, 李东杰, 朴文花. 宁夏地区4 257例输血患者 不规则抗体检测结果分析[J]. 山东大学学报（医学版）, 2014, 52(S2): 46-47.
[2] 邱少慧1,郭明2. 山东临沂地区RhD阴性无偿献血人群中RHD基因变异体的分析[J]. 山东大学学报(医学版), 2012, 50(8): 112-.
[3] 郭伟1,徐群2,邵超鹏3 . 304例Rh阴性孕产妇的RhD同种免疫分析[J]. 山东大学学报(医学版), 2010, 48(11): 94-97.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 马青源,蒲沛东,韩飞,王超,朱洲均,王维山,史晨辉. miR-27b-3p调控SMAD1对骨肉瘤细胞增殖、迁移和侵袭作用的影响[J]. 山东大学学报 (医学版), 2020, 1(7): 32 -37 .
[2] 张宝文,雷香丽,李瑾娜,罗湘俊,邹容. miR-21-5p靶向调控TIMP3抑制2型糖尿病肾病小鼠肾脏系膜细胞增殖及细胞外基质堆积[J]. 山东大学学报 (医学版), 2020, 1(7): 7 -14 .
[3] 付洁琦,张曼,张晓璐,李卉,陈红. Toll样受体4抑制过氧化物酶体增殖物激活受体γ加重血脂蓄积的分子机制[J]. 山东大学学报 (医学版), 2020, 1(7): 24 -31 .
[4] 丁祥云,于清梅,张文芳,庄园,郝晶. 胰岛素样生长因子II在84例多囊卵巢综合征患者颗粒细胞中的表达和促排卵结局的相关性[J]. 山东大学学报 (医学版), 2020, 1(7): 60 -66 .
[5] 肖娟,肖强,丛伟,李婷,丁守銮,张媛,邵纯纯,吴梅,刘佳宁,贾红英. 两种甲状腺超声数据报告系统诊断效能的比较[J]. 山东大学学报 (医学版), 2020, 1(7): 53 -59 .
[6] 郭志华,赵大庆,邢园,王薇,梁乐平,杨静,赵倩倩. Ⅰ期端端吻合术治疗重度颈段气管狭窄临床分析[J]. 山东大学学报 (医学版), 2020, 1(7): 72 -76 .
[7] 罗昕,何兵,聂清生,侯震波,董军,李玉花,曾祥芹,刘伟,孔德民,曹金凤. 磁共振扩散加权成像单指数模型与扩散峰度成像模型在61例肾透明细胞癌分级中的对比[J]. 山东大学学报 (医学版), 2020, 1(7): 89 -95 .
[8] 徐继禧,陈伟健. 髓内弥漫性中线胶质瘤伴H3 K27M突变1例[J]. 山东大学学报 (医学版), 2020, 1(7): 96 -101 .
[9] 索东阳,申飞,郭皓,刘力畅,杨惠敏,杨向东. Tim-3在药物性急性肾损伤动物模型中的表达及作用机制[J]. 山东大学学报 (医学版), 2020, 1(7): 1 -6 .
[10] 龙婷婷,谢明,周璐,朱俊德. Noggin蛋白对小鼠脑缺血再灌注损伤后学习和记忆能力与齿状回结构的影响[J]. 山东大学学报 (医学版), 2020, 1(7): 15 -23 .
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发