Application of Rh antigen typing in a maternal transfusion
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摘要: 探讨在特殊情况下Rh分型在输血医学中的意义。采用微注凝胶技术，对1例不规则抗体阳性的产妇及其新生儿进行ABO血型鉴定和Rh分型。对产妇意外抗体进行鉴定，对新生儿进行Rh系统溶血病检测，对供者进行Rh分型并与产妇进行交叉配血。产妇血型为AB型Rhccdee，新生儿血型为AB型RhCcDee。产妇及新生儿血浆中意外抗体为抗C、抗D。新生儿红细胞表面可释放出抗C、抗D抗体。筛选供者5例与其中1例配合，供者Rh血型为ccdee。母婴Rh血型不同可导致Rh系统意外抗体产生，在多次输血及Rh阴性受者宜进行Rh分型。多次受血者、Rh阴性受血者及孕产妇输血宜进行Rh同型输注。Abstract: To investigate the significance of Rh typing in transfusion medicine under special conditions. ABO blood group identification and Rh typing were performed in a case of irregular antibody positive puerpera and neonate by microinjection gel technique. Identification of maternal accidental antibodies was performed. The neonates were tested for Rh system hemolytic disease. Rh typing of the donor and cross matching with the puerpera were performed. The maternal blood type was AB Rhccdee, and the neonatal blood type was AB RhCcDee. Accidental antibodies in maternal and neonatal plasma were anti-C and anti-D antibodies. Neonatal erythrocyte surface could release anti-C, anti-D antibodies. Five donors were screened and matched with one of them. The donor's Rh blood type was ccdee. The difference of Rh blood type between mother and child may lead to the accidental antibody production in Rh system. Rh typing should be performed in patients with multiple transfusions and Rh negative recipients. Rh homotype infusion should be performed for multiple recipients, Rh-negative recipients and pregnant women.
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Key words:
- irregular antibody /
- anti-G antibody /
- Rh phenotype /
- Rh homotype transfution
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表 1 产妇抗体筛查格局表
Rh-hr Rh-hr Kell Duffy kidd XG Lewis MNS P LU 结果 D C E c e f Cw V K k Kpa Kpb Jsa Jsb Fya Fyb JKa JKb Xga Lea Leb M N S s P1 Lua Lub 盐水 卡 R1R1 + + 0 0 + 0 0 0 0 + 0 + / + 0 + 0 + + 0 + + + 0 + +s 0 + 0 + R2R2 + 0 + + 0 0 0 0 + + 0 + / + + 0 + 0 + 0 + + + 0 + + 0 + 0 + rr 0 0 0 + + + 0 0 0 + 0 + / + 0 + 0 + + + 0 + 0 + 0 0 0 + 0 0 Patient Cells 0 0 
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表 2 产妇血浆处理前后、新生儿血浆及红细胞放散后抗体鉴定表
序号 Rh-hr kidd MNSs Duffy Diego Kell Lewis D C E c e JKa JKb M N S s Mur Fya Fyb Dia Dib K k Lea Leb 1 + + 0 0 + + 0 + + + + 0 + 0 0 / 0 + + + 2 + + + + + + 0 + 0 0 + 0 + 0 0 / 0 + + + 3 + + + + + + 0 0 + 0 + 0 + + + / 0 + + + 4 + 0 + + 0 0 + 0 + 0 + 0 + 0 0 / 0 + 0 + 5 + 0 + + + 0 + + + 0 + 0 + 0 0 + 0 + 0 + 6 + + 0 0 + 0 + + 0 + + 0 + 0 0 / 0 + + + 7 0 + 0 0 + + + + 0 0 + 0 + 0 0 / 0 + 0 + 8 + + + + + + + + + + + 0 0 + 0 / 0 + 0 + 9 0 0 0 + + + + 0 + 0 + 0 + 0 0 + 0 + + 0 10 + + + + + + + + + 0 + + + 0 +w / 0 + + + 自身 序号 P DO Yt 产妇血浆抗体鉴定 吸收后产妇血浆抗体鉴定 新生儿血浆游离抗体鉴定 新生儿红细胞表面抗体鉴定 P1 DOa DOb Yta Ytb 盐水 卡 盐水 卡 盐水 卡 盐水 卡 1 + / / / / 0 + 0 + 0 + 0 + 2 0 / / / / 0 + 0 + 0 + 0 + 3 + / / / / 0 + 0 + 0 + 0 + 4 + / / / / 0 + 0 0 0 + 0 + 5 + 0 + + + 0 + 0 0 0 + 0 + 6 + / / / / 0 + 0 + 0 + 0 + 7 + / / / / 0 + 0 + 0 + 0 + 8 0 / / / / 0 + 0 + 0 + 0 + 9 0 0 + + + 0 0 0 0 0 0 0 0 10 0 / / / / 0 + 0 + 0 + 0 + 自身 0 0 0 0 0 + 0 +
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