中国输血杂志2025，Vol.38Issue(6)：766-771,6.DOI:10.13303/j.cjbt.issn.1004-549x.2025.06.003
"亚洲型"DEL孕妇免去抗-D监测的临床应用
Clinical application of exempting anti-D monitoring in pregnant women with Asian-type DEL
摘要
Abstract
Objective To evaluate the feasibility of exempting Asian-type DEL pregnant women from anti-D monitoring and RhD immunoglobulin prophylaxis injections by comparing and analyzing the clinical incidence of anti-D alloimmuniza-tion between Asian-type DEL pregnant women and true RhD-negative pregnant women.Methods A total of 165 pregnant women who were initially screened as RhD negative by the saline method and received medical treatment in our hospital from December 2022 to August 2024 were collected as the research subjects.Absorption and elution tests,DEL genotyping,and gene sequencing were used to divide the pregnant women into the Asian-type DEL group and the true negative group.After obtaining informed consent,the following clinical management plan was implemented for pregnant women with Asian-type DEL:exemption from routine anti-D antibody detection,exemption from RhD immunoglobulin prophylaxis,and transfusion of RhD-positive red blood cells.Blood samples of newborns were sent for examination of hemolytic disease of the fetus and newborn(HDFN).The routine management plan was implemented for true negative pregnant women.The incidence of allo-immunization and HDFN was comparatively analyzed between the two groups.Results Among 165 initially screened RhD negative pregnant women,serological testing and genotyping confirmed 42 as Asian-type DEL,9 as D variant,and 114 as true negative.Among 42 pregnant women with Asian-type DEL,3 cases tested positive for HDFN due to receiving RhD im-munoglobulin prophylaxis injection.The remaining 39 cases were exempted from anti-D testing after being fully informed of the risk,and did not receive RhD immunoglobulin prophylaxis.The HDFN tests were all negative.In the true negative group,anti-D antibodies were detected in 20 cases,of which 6 cases tested positive for HDFN.A pregnant woman with Asi-an-type DEL did not show RhD homologous immune response after receiving 2 units of RhD positive red blood cells.Statis-tical analysis revealed a significantly lower risk of anti-D alloimmunization in Asian-type DEL carriers compared to true D-negative pregnant women(P<0.05).Conclusion Pregnant women with Asian-type DEL can be exempted from routine anti-D antibody testing and do not require routine RhD immunoglobulin prophylaxis injections.关键词
"亚洲型"DEL/抗-D/RhD免疫球蛋白/等位基因Key words
Asian-type DEL/anti-D/RhD immunoglobulin/allele分类
临床医学引用本文复制引用
易品,欧子羽,孙肖霄,王明明,伍昌林,邵超鹏.."亚洲型"DEL孕妇免去抗-D监测的临床应用[J].中国输血杂志,2025,38(6):766-771,6.基金项目
广东省医学科研基金项目(B2024148)、深圳市自然科学基金项目(JCYJ20240813141121029)、深圳市血液中心科研课题(SZBC202314) （B2024148）
