Yang Gui-Lin, Zhang Tao, Li Chun-Li, Zhang Hong-Peng, Wu Ying-Ying, Li Sheng-Lan, Wan Kuai, Yang Yun-Ping
Department of Blood Transfusion, Women and Children's Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing 401147, China.
Department of Blood Transfusion, Women and Children's Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children, Chongqing 401147, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Jun;32(3):868-874. doi: 10.19746/j.cnki.issn.1009-2137.2024.03.034.
To analyze the distribution characteristics of Rh phenotype in pregnant and postpartum women in Chongqing area, and to explore the clinical significance of Rh phenotype in pregnant and postpartum women and the feasibility of Rh phenotype compatible blood transfusion.
The ABO blood group and Rh phenotype of 65 161 pregnant and postpartum women were detected by microcolumn gel method, and 48 122 males in the same period were taken as controls. The data were analyzed by Chi-square test.
There were 112 870 cases (99.64%) of RhD in 113 283 samples. In RhD cases, CCDee (48.39%) and CcDEe (32.88%) were the main phenotypes. The first case of D-- phenotype in Chongqing area was detected. 413 cases (0.36%) of RhD were detected, with ccdee (52.78%) and Ccdee (33.41%) as the main phenotypes. Compared with RhD group, RhD group showed statistically significant difference in Rh phenotype distribution ( < 0.01). Among 65 161 maternal samples, the positive rate of 5 antigens of Rh blood group from high to low was D > e > C > c > E, and there was no significant difference compared with male samples ( >0.05). There was no significant difference in the distribution of Rh phenotype between males and pregnant/postpartum women, as well as between pregnant/postpartum women with different ABO blood groups ( >0.05). In pregnant and postpartum women, there was no significant difference in distribution of Rh phenotype among the normal pregnancy population, the population with adverse pregnancy history, the population using human assisted reproductive technology (ART) and the population with infertility ( >0.05). There was no significant difference in the distribution of Rh phenotype between the 4 populations mentioned above and the inpatients in the local general Grade A hospitals and the blood donors ( >0.05). In RhD positive pregnant and postpartum women, the probability of finding compatible blood for CcDEe phenotype was 100%, the probability of finding compatible blood for CCDee, CcDee and CCDEe phenotypes was 45%-60%, the probability of finding compatible blood for ccDEE, ccDEe and CcDEE phenotypes was 5%-10%, and the probability of finding compatible blood for other phenotypes was lower than 0.5%. The supply of blood with CCDee and ccDEE phenotypes can meet the compatible transfusions requirements of 7 Rh phenotypes in more than 99% of patients.
Rh phenotype detection should be carried out for pregnant and postpartum women, and it is feasible to carry out Rh phenotype-matched or compatible blood transfusion for pregnant and postpartum women who need blood transfusion.
分析重庆地区孕产妇Rh血型表型分布特征，探讨孕产妇Rh血型表型的临床意义及Rh血型表型配合性输血的可行性。
采用微柱凝胶法检测65161例孕产妇的ABO血型及Rh血型表型，并以同期48122例男性作为对照。采用卡方检验进行数据分析。
113283份样本中RhD阳性112870例（99.64%）。在RhD阳性者中，以CCDee（48.39%）和CcDEe（32.88%）为主要表型。检测到重庆地区首例D--表型。检测到RhD阴性413例（0.36%），以ccdee（52.78%）和Ccdee（33.41%）为主要表型。RhD阴性组与RhD阳性组Rh血型表型分布差异有统计学意义（<0.01）。65161例孕产妇样本中，Rh血型5种抗原阳性率由高到低依次为D>e>C>c>E，与男性样本比较差异无统计学意义（>0.05）。男性与孕产妇、不同ABO血型的孕产妇之间Rh血型表型分布差异无统计学意义（>0.05）。孕产妇中，正常妊娠人群、有不良孕产史人群、采用人类辅助生殖技术（ART）人群及不孕人群Rh血型表型分布差异无统计学意义（>0.05）。上述4类人群与当地普通甲等医院住院患者及献血者Rh血型表型分布差异无统计学意义（>0.05）。RhD阳性孕产妇中，CcDEe表型找到配合血概率为100%，CCDee、CcDee和CCDEe表型找到配合血概率为45% - 60%，ccDEE、ccDEe和CcDEE表型找到配合血概率为5% - 10%，其他表型找到配合血概率低于0.5%。CCDee和ccDEE表型血液供应能满足99%以上患者7种Rh血型表型的配合性输血需求。
应开展孕产妇Rh血型表型检测，对需输血的孕产妇进行Rh血型表型配合性或相容性输血具有可行性。
