免疫血液学中的难题：弱D抗原
Difficulties in Immunohaematology : The Weak D Antigen.
作者信息
Kumar H, Mishra D K, Sarkar R S, Jaiprakash M
机构信息
Associate Professor, Department of Transfusion Medicine, AFMC, Pune.
Classified Specialist (Pathology and Haematology), AHDC(R&R), Delhi Cantt.
出版信息
Med J Armed Forces India. 2005 Oct;61(4):348-50. doi: 10.1016/S0377-1237(05)80062-0. Epub 2011 Jul 21.
BACKGROUND
The Rh blood system is one of the most polymorphic and immunogenic systems known to humans. The expression of Rh blood group antigen is complex. The Rh D antigen is the most important of the antigens that constitute the Rh antigen system. In most cases, D antigen can easily be detected. However, due to variability of expression, weak forms antigen are encountered. The reactivity of weak D with antisera is variable and presents as a problem in blood banking.
METHODS
A retrospective analysis for a five-year period was done. Blood samples that were negative for Rh D by immediate spin tube method were tested for weak D antigen by additional lab tests.
RESULT
Of 34932 serial Rh grouping tests done in our Blood Bank, the incidence of weak D Rh antigen was 0.189%. All these were confirmed by the antiglobulin test.
CONCLUSION
These patients present as a problem for the blood banker and a curiosity to the clinician. Although uncommon, all health care workers should be aware of this entity to avoid anti D alloimmunisation.
背景
Rh血型系统是人类已知的多态性和免疫原性最强的系统之一。Rh血型抗原的表达很复杂。Rh D抗原是构成Rh抗原系统的最重要抗原。在大多数情况下，D抗原很容易检测到。然而，由于表达的变异性，会遇到弱形式的抗原。弱D与抗血清的反应性是可变的，这在血库中是一个问题。
方法
进行了为期五年的回顾性分析。通过即时离心试管法检测Rh D呈阴性的血样，通过额外的实验室检测来检测弱D抗原。
结果
在我们血库进行的34932次连续Rh血型分组检测中，弱D Rh抗原的发生率为0.189%。所有这些均通过抗球蛋白试验得到证实。
结论
这些患者给血库工作人员带来了问题，也引起了临床医生的好奇。尽管不常见，但所有医护人员都应了解这一情况，以避免抗D同种免疫。
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