摘要
目的:分析并总结武汉地区临床常见不规则抗体所致新生儿溶血的抗体分布特点。方法:对武汉血液中心2006—2016年间所有送检新生儿溶血病的标本中,由不规则抗体导致的新生儿溶血病溶血筛查试验结果进行回顾性分析。结果:344例由不规则抗体导致的新生儿溶血病致病抗体主要来自于Rh和MNS两个血型系统,且Rh系统以抗-D、抗-E比较常见。其他抗体主要还包括抗-M、抗-Mur、抗-Jka、抗-Jkb、抗-Jk3、抗-Fya、抗-Dia、抗-Lea等。Rh血型系统抗体325例(94.48%),其中209例为Rh阴性血孕产妇抗-D抗体、MNS血型系统13例(3.78%)、Kidd血型系统3例(0.87%)、Duffy血型系统1例(0.29%)、Diego血型系统1例(0.29%)、Lewis血型系统1例(0.29%)。结论:武汉地区2006—2016年由不规则抗体导致的新生儿溶血的不规则抗体按照发生频率依次为Rh血型系统、MNS血型系统、Kidd血型系统、Duffy血型系统、Diego血型系统、Lewis血型系统,其中数量最多的是Rh阴性血孕产妇产生的抗-D抗体,且有多次妊娠或输血史产妇占近一半,鉴于有免疫史的孕妇其新生儿溶血呈高发态势,应对Rh阴性血孕产妇应进行产前预防和D阴性孕妇的相容性输注,以避免再次妊娠产生抗体。并对有过多次妊娠或输血史的产妇,加强产前血型单特异性抗体鉴定筛查及表型筛查,尽量使用血型抗原相匹配的供者血液。
Objective:To analyze and summarize the distribution characteristics of antibody in neonates caused by irregular antibodies in Wuhan.Method:Towards all specimens of neonatal hemolytic disease in Wuhan Blood Center from 2006 to 2016,the results of hemolytic test of neonatal hemolytic disease caused by irregular antibodies were retrospectively analyzed.Result:Among 344 cases of neonatal hemolytic disease caused by irregular antibodies,the disease-causing antibodies were mainly from Rh and MNS blood-group system,in which Rh system to antiD,anti-E were more common.Other antibodies mainly included anti-M,anti-Mur,anti-Jka,anti-Jkb,anti-Jk3,antiFya,anti-Dia,anti-Leaand so on.In which Rh blood-group system was 325 cases accounting for 94.48%,MNS blood-group system wsa 13 cases accounting for 3.78%,Kidd blood-group system was 3 cases accounting for0.87%,Duffy blood-group system was 1 case accounting for 0.29%,Diego blood-group system was 1 case accounting for 0.29%and Lewis blood-group system was 1 case accounting for 0.29%.Conclusion:The irregular antibodies that cause hemolysis of neonates in Wuhan according to the frequency of occurrence were as following:Rh,MNS,Kidd,Duffy,Diego and Lewis system.The largest number of them were anti-D antibodies produced by Rh negative blood pregnant women.Maternal history accounted for nearly half of pregnancy or transfusion history.And in view of the high incidence of hemolysis in pregnant women with immune history,pregnant women with Rh negative blood should receive prenatal prophylaxis,as well as compatible blood transfusion for D negative pregnant women,which will avoid antibodies in re-pregnancy.For pregnant women with multiple pregnancy or blood transfusion history,they should strengthen the identification screening and phenotypic screening about prenatal blood monospecific antibody,and use donor blood matching blood group antigens of the receiver as much as possible.
作者
杨茹
李刚
何欣
任明
YANG Ru;LI Gang;HE Xin;REN Ming(Department of Transfusion Labortory,Wuhan Blood Center,Wuhan,430030,China)
出处
《临床血液学杂志（输血与检验）》
2019年第1期109-112,共4页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
关键词
不规则抗体
新生儿溶血病
irregular antibody
neonatal hemolytic disease
