Wu Yuan-jun, Wu Yong, Chen Bao-chan, Liu Yan
Department of Transfusion of The Affiliated TungWah Hospital of Sun Yet-sen University, Dongguan, China.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2008 Jun;24(6):604-6.
To study the prevalence and distribution of anti-Rh blood group antibodies in Chinese population and its clinical significance.
Irregular antibodies were screened and identified by Microcolum Gel Coomb's test. For those identified as positive anti-Rh samples, monoclonal antibodies (anti-D, -C, -c, -E and -e) were used to identify the specific antigen and confirm the accuracy of the irregular antibody tests. The titers, Ig-types and 37 Degrees Celsius-reactivity were tested to confirm its clinical significance. For evaluation of the origin of irregular antibodies, histories of pregnancy and transfusion were reviewed. For the newborns who had positive antibodies, their mothers were tested simultaneously to confirm the origin of the antibodies.
47 out of 54 000 (0.087%) patients were identified as positive with Rh blood group antibodies.Of them, 27 cases had history of pregnancy, 13 had transfusion and 1 had the histories of both. 6 newborns had antibodies derived form their mothers. The specificity of the antibody was as follows: 29 with anti-E (61.70%), 8 with anti-D (17.02%), anti-cE 5(10.64%), 4 with anti-c (8.51%) and 1 with anti-C (2.13%). All the 47 Rh blood group antibodies were IgG or IgG+IgM, and were reactive to red blood cells with corresponding antigens at 37 Degrees Celsius, with a highest titer of 1:4 096.
The prevalence of Rh antibodies is lower in Chinese population as compared with that in White population.Of all the antibodies, anti-E is most frequently identified and anti-D was declining. Alloimmunization by pregnancy and transfusion is the major cause of Rh antibody production. Rh blood group antibodies derived from mothers are the major cause of Non-ABO-HDN.
研究中国人群中抗Rh血型抗体的流行情况、分布及其临床意义。
采用微柱凝胶抗人球蛋白试验筛查和鉴定不规则抗体。对于鉴定为抗Rh阳性的样本，使用单克隆抗体（抗-D、-C、-c、-E和-e）鉴定特异性抗原并确认不规则抗体检测的准确性。检测抗体效价、免疫球蛋白类型及37℃反应性以确定其临床意义。通过回顾妊娠和输血史评估不规则抗体的产生原因。对于抗体阳性的新生儿，同时检测其母亲以确定抗体来源。
54000例患者中47例（0.087%）Rh血型抗体阳性。其中，27例有妊娠史，13例有输血史，1例两者皆有。6例新生儿的抗体来自母亲。抗体特异性如下：抗-E 29例（61.70%），抗-D 8例（17.02%），抗-cE 5例（10.64%），抗-c 4例（8.51%），抗-C 1例（2.13%）。47例Rh血型抗体均为IgG或IgG+IgM，在37℃时与相应抗原的红细胞发生反应，最高效价为1:4096。
与白种人群相比，中国人群中Rh抗体的流行率较低。在所有抗体中，抗-E最常见，抗-D呈下降趋势。妊娠和输血引起的同种免疫是Rh抗体产生的主要原因。来自母亲的Rh血型抗体是引起非ABO血型新生儿溶血病的主要原因。
