探讨ABO、RhD血型调查与建立Rh表型库在安全输血中的临床意义

目的 调查河北省邯郸市峰峰矿区ABO、RhD血型在人群中的分布情况，分析患者不规则抗体筛查结果，探讨ABO、Rh血型调查与建立Rh表型库在安全输血中的临床意义。方法 收集我院8 000例住院患者ABO血型及RhD血型的检测结果，对需输血的患者5 000例进行不规则抗体检测，阳性结果标本进一步行抗体特异性鉴定。随机选取3 000袋RhD阳性滤白红细胞悬液样本检测Rh表型，通过电脑建立献血者Rh表型数据库，探讨其在输血中的重要意义及价值。结果 8 000例患者中ABO血型分布情况从多到少依次为B型血（32.02%）、O型血（28.98%）、A型血（27.01%）、AB型血（11.99%）。不同年龄组间ABO血型分布情况差异有统计学意义（P＜0.05），不同性别组中ABO血型分布情况差异无统计学意义（P＞0.05）。8 000例患者中RhD阴性48例（0.60%）。男性和女性 Rh血型分布差异无统计学意义（P＞0.05）。5 000例需输血患者的血样标本中不规则抗体阳性者30例（0.60%），Rh血型系统抗体阳性19例（63.33%），抗-E检出率最高。不规则抗体的检出率女性显著高于男性，差异有统计学意义（P＜0.05）。3 000例RhD阳性献血者血样标本Rh血型表型共8种，其中CCDee检出率最多，其次为CcDEe，DcDEE和ccDee检出率较少。结论 ABO血型的分布与地域及年龄有关；临床上除在患者输血前进行不规则抗体筛查，应进一步检测其抗体特异性；建立献血者Rh表型数据库有利于预防因Rh表型不符输血引起的溶血性输血反应，对于临床安全输血工作具有重大意义。

To explore the clinical significance of ABO,Rh blood type investigation and establishment of Rh phenotype library in safe blood transfusion

Objective To investigate the distribution of ABO，RhD blood type in Fengfeng mining area of Handan City, Hebei Province, to analyze the results of irregular antibody screening, and to explore the clinical significance of ABO、 Rh blood type investigation and establishment of Rh phenotype bank in safe blood transfusion. Methods The results of ABO blood type and RhD blood type of 8 000 inpatients in our hospital were collected. The irregular antibody was detected in 5 000 patients who needed blood transfusion. The positive samples were further identified with antibody specificity. Three thousand bags of RhD positive filter red blood cell suspension were randomly selected to detect Rh phenotype, and the Rh phenotype database of blood donors was established by computer to explore its significance and value in blood transfusion. Results The distribution of ABO blood type in 8 000 patients was B blood(32.02%), O blood(28.98%), A blood(27.01%), AB blood(11.99%). There was significant difference in ABO blood type distribution among different age groups(P＜0.05), but there was no significant difference in ABO blood type distribution between different sex groups(P＞0.05). RHD was negative in 48 of 8 000 patients(0.60%). There was no significant difference in Rh blood type distribution between male and female(P＞0.05). Among the 5 000 blood samples of patients who needed blood transfusion, 30(0.60%) were positive for irregular antibody, 19(63.33%) were positive for Rh blood type system antibody, and the detection rate of anti-E was the highest. The detection rate of irregular antibody in female was significantly higher than that in male(P＜0.05). There were 8 Rh blood type phenotypes in 3 000 RhD positive blood donors, of which CCDee was the most frequently detected, followed by CcDEe，DcDEE and ccDee were less frequently detected. Conclusion The distribution of ABO blood type is related to region and age. In addition to irregular antibody screening before blood transfusion, the antibody specificity should be further tested. The establishment of Rh phenotype database of blood donors is conducive to prevent hemolytic blood transfusion reaction caused by Rh phenotype mismatch, which is of great significance for clinical safe blood transfusion.