血液抗-D抗体检测在RhD阴性患者输注RhD阳性同型红细胞中的效果分析

目的研究RhD阴性患者输注与其血型相同的RhD阳性红细胞血液后,患者抗-D抗体的水平。方法收集该院2010年1月至2016年1月输注RhD阳性同型红细胞的20例RhD阴性患者的临床资料,分析其在输血前及输血后10、20、30、60、90d的抗-D抗体水平及RhD阳性患者的效价。结果输注RhD阳性同型红细胞血液的20例RhD阴性患者,在输血后90d内有6例患者表现为RhD阳性,其中男性RhD阳性率为25.0%(3/12)、女性RhD阳性率为37.5%(3/8)。3例RhD阳性的女性患者抗-D抗体效价分别为35、278、508。结论 RhD阴性患者输注RhD阳性同型红细胞血液,可刺激机体免疫机制,产生红细胞表面抗-D抗体,且部分RhD阴性患者的红细胞表型会发生改变。

Analysis on effect of blood anti-D antibody detection in infusing RhD positive homotype RBC for patients with RhD negative

Objective To investigate the anti-D antibody level after infusing homotype RhD positive RBC in the patient with RhD negative.Methods The clinical data in 20 cases of RhD negative infusing homotype RhD positive RBC in our hospital from January 2010 to January 2016 were collected.The anti-D antibody levels before blood infusion and on 10,20,30,90 d after blood infusion and the titers in the patients with RhD positive were analyzed.Results Among 20 cases of RhD negative infusing RhD positive homotype RBC blood,6 cases were RhD positive within 90 d after blood infusion,in which the RhD positive rates were 25%(3/12) in male and 37.5%(3/8) in female.The anti-D antibody titers in 3 cases of RhD positive were 35,278 and 508 respectively.Conclusion Infusing RhD positive RBC blood in the patients with RhD negative can stimulate the immune mechanism,generates the anti-D antibody at RBC surface.Moreover the RBC phenotype in partial patients with RhD negative may change.