CAJ | 학술논문

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109000例,共检出 Rh 血型抗体96例,检出率为0.088%,其中有妊娠史者68例,有输血史者5例,既有妊娠史又有输血史者6例,抗体来自母体的新生儿17例；抗体的特异性为：抗-E 65例(67.710%)、抗-cE 12例(12.500%)、抗-D 8例(8.330%)、抗-c 7例(7.291%)、抗-C 2例(2.083%)、抗-e 2例(2.083%)；96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4~2048。结论抗-D 的检出率呈逐步降低趋势；在检出的 Rh 血型抗体中,抗-E 和抗-cE 占绝对多数；妊娠和输血引起的同种免疫是 Rh 血型抗体产生的主要原因；新生儿自母体被动获得的 Rh 血型抗体是 Rh-新生儿溶血病最主要的致病抗体。
목적：조사 Rh혈형항체적검출솔급기특이성분포특점,분석 Rh혈형항체적림상의의급산생규률。방법채용미주응효항구단백기술사사화감정홍세포혈형불규칙항체,대감정위 Rh 혈형항체자,채용단극륭항-D、항-C、항-c、항-E、항-e 감정홍세포 Rh 혈형항원,이학인항체적준학성；검측항체적효개、Ig 류형급37℃반응성,이명학기림상의의；순문잉산사、수혈사,여과위신생인,검측기모친혈장중시부유상동특이성적항체,이분석항체산생적원인。결과취진자109000례,공검출 Rh 혈형항체96례,검출솔위0.088%,기중유임신사자68례,유수혈사자5례,기유임신사우유수혈사자6례,항체래자모체적신생인17례；항체적특이성위：항-E 65례(67.710%)、항-cE 12례(12.500%)、항-D 8례(8.330%)、항-c 7례(7.291%)、항-C 2례(2.083%)、항-e 2례(2.083%)；96례 Rh 혈형항체균위 IgG,혹 IgG+IgM 류,37℃균가여구유상응항원적홍세포반응,항체효개개우4~2048。결론항-D 적검출솔정축보강저추세；재검출적 Rh 혈형항체중,항-E 화항-cE 점절대다수；임신화수혈인기적동충면역시 Rh 혈형항체산생적주요원인；신생인자모체피동획득적 Rh 혈형항체시 Rh-신생인용혈병최주요적치병항체。
Objective To analyze the positive rate of specific distribution characteristics in Rh blood group antibody,analyze the clinical significance of Rh blood group antibody and rules.Methods The micro column gel anti globulin technique was used to screen and identify irregular red blood cell antibodies,for patients with Rh blood group antibody,monoclonal anti-D,anti-C,anti-c, anti-E,anti-e were used to identify Rh blood group antigen to confirm the accuracy of detection.The antibody titer,Ig-type and 37℃ reactive were used to determine its clinical significance.Through asking pregnancy history,history of blood transfusion,under-standing whether the same specificity of the antibody in maternal plasma if the patient was newborn,the causes of antibody were an-alyzed.Results In 109 000 patients,Rh blood group antibodies were detected in 96 cases,the positive rate was 0.088%,which has a history of pregnancy in 68 cases,5 cases had history of blood transfusion,both pregnancy history and history of blood transfusion in 6 cases,1 7 cases of neonatal maternally derived antibody.Antibody specificity:65 cases of anti-E(67.710%),12 cases of anti-cE (12.500%),8 cases of anti-D (8.330%),7 cases of anti-c(7.291%),2 cases of anti-C (2.083%),2 cases of anti-e(2.083%).96 cases of Rh blood group antibodies were IgG or IgG+IgM class,37 ℃ reaction could be with the corresponding antigen of red blood cell,antibody titer between 4-2 048.Conclusion Anti-D detection rate shows a trend of gradually decreasing.In Rh blood group antibody detection,anti-E and anti-cE account for an absolute majority.Alloimmune caused by pregnancies and blood transfusion is the main reason of Rh blood group antibody production from Rh blood group antibody.Neonatal maternal passive getisa Rh-HDN is the main pathogenic antibody.