输血前开展A_2/A_2B亚型和Rh弱D血型检测的临床意义

目的：探讨输血前开展A2/A2B 亚型和 Rh 弱 D 血型检测的临床意义。方法：通过对2009年1-12月献血者中初筛Rh（D）阴性324人次、A型15123人次、AB型6049人次为基数,计算A2/A2B亚型和Rh弱D血型的检出比率;χ2检验比较2008年与2009年A型和AB型输血患者溶血性输血反应发生率、无效输血发生率。结果：本地区Rh（D）阴性中Rh弱D比率为11.11%;A2亚型比率为2.06%;A2B亚型比率为2.13%;2008-2009年A型、AB型溶血性输血反应的发生率分别由0.098%、0.136%降为0.037%、0.039%;无效输血的发生率分别由12.37%、17.35%降为7.67%、8.04%。结论：输血前开展A2/A2B亚型检测,为患者提供更相合的血液,可以大幅度降低临床溶血性输血反应发生率,降低临床无效输血发生率,确保患者输血安全,提高临床输血效果;Rh弱D血型检测可以更好地指导临床稀有血型患者的输血安全,节约宝贵的血液资源。

Clinical significance of detection of A_2/A_2B subtypes and Rh weak D blood group before blood transfusion

Objective：To discuss the clinical significance of detection of A2/A2B subtypes and Rh weak D blood group before blood transfusion.Method：The detection rate of A2/A2B subtypes and Rh weak D blood group were calculated by the amount of blood donors which were in Rh negative group,A and AB group in 2009.The hemolytic transfusion reaction rate,ineffective rate in A and AB group patients from 2008 to 2009 were compared by Chi-square test.Result：The rate of Rh weak D in Rh negative group was 11.11% in this area;the rate of A2 in A group was 1.06%;and the rate of A2B in AB group was 2.13%.From 2008 to 2009 the hemolytic transfusion reaction rate in A group patients decreased from 0.098% to 0.037%,and in AB group patients decreased from 0.136% to 0.039%.The ineffective rate in A group patients decreased from 12.37% to 7.67%,and in AB group patients decreased from 17.35% to 8.04%.Conclusion：The detection of A2/A2B subtypes before transfusion could give patients more correct choice,greatly decrease the rate of hemolytic transfusion reaction as well as ineffective rate,guarantee patient safety in transfusion,and improve the effect of clinical transfusion.The detection of Rh weak D blood group could guide better for the transfusion safety of clinical rare blood group antigen patients,and save blood resources.