中国输血杂志2025，Vol.38Issue(5)：678-683,6.DOI:10.13303/j.cjbt.issn.1004-549x.2025.05.013
RhCE同种抗体阳性血液病患者的多抗原拓展配型输血研究
Research on multi antigen extended matching transfusion in RhCE alloantibody positive patients with blood diseases
摘要
Abstract
Objective To analyze the changes in homologous immunity after RhCE-matched transfusion in positive pa-tients with RhCE blood group antibodies,and to provide precise transfusion strategies for chronic anemia patients.Methods Patients with chronic anemia in our hospital from January 2020 to March 2024(continuously receiving blood transfusions for more than 6 months)were enrolled,and 63 cases of unexpected antibody screening positive and identified as RhCE blood group antibodies were selected as the research subjects.The changes in unexpected antibody yield rate after ABO and RhCcDEe isotype blood transfusion were observed.Patients with MNS,Kidd,or Lewis blood group antibodies were screened for corresponding negative donors using monoclonal antibodies for extended typing transfusion based on RhCcEe typing,and the changes in unexpected antibody yield rate after transfusion were observed.Blood group genotyping was per-formed when serological techniques failed to resolve discrepancies or detect abnormal antigen expression.Results After RhCcDEe-matched transfusions,RhCE antibodies disappeared in 62 patients,while 1 patient developed anti-Ce.The latter did not develop blood type isotype immunity after receiving RhccEE donor blood.Among the 62 patients,9 developed unex-pected antibodies against other systems:anti-M(4 cases),anti-Mur(2),anti-S(1),anti-Jka(1),and anti-Lea(1).No additional alloimmunization occurred after extended antigen-matched transfusions.A patient with serologically weak e phenotype was genotyped as DCe/DcE,with gene sequencing revealing an 827C>A mutation in exon 6 of the RHCE gene,forming the RHCE*01.31 allele.Conclusion Precise transfusion strategies incorporating RhCE,MNS,Kidd,and Lewis blood group antigen typing can reduce the probability of blood group homologous immunity.RhCE complex antibodies and RhCE variants pose difficulties for clinical RhCE typing transfusion,which can be addressed through cross-matching and ge-netic analysis.关键词
不规则抗体/RhCE/拓展配型/精准输血Key words
unexpected antibodies/RhCE/extended matching/accurate blood transfusion分类
医药卫生引用本文复制引用
易品,王明明,朱奕,党鑫堂,欧子羽,吴凡,邵超鹏,伍昌林..RhCE同种抗体阳性血液病患者的多抗原拓展配型输血研究[J].中国输血杂志,2025,38(5):678-683,6.基金项目
广东省医学科研基金项目(B2024148)、深圳市科技计划项目(202408133002671)、深圳市血液中心科研课题(SZBC202314) （B2024148）
