摘要
Abstract
Objective To analyze the distribution of major antigen phenotypes in the Rh blood group system and evaluate the efficacy and safety of Rh-matched or Rh-reduced-antigen transfusion in patients requiring chronic transfusions.Methods A retrospective study was conducted on 32 256 blood samples from hospitalized patients,6 120 from healthy blood donors,and 6 136 from healthy subjects at Hangzhou First People's Hospital between May 2022 and December 2023.Rh blood group antigen phenotypes were determined using Rh phenotyping cards on an automated blood grouping system and recorded to establish an Rh phenotype database.Among 166 patients requiring chronic transfusions during the same period,83 received conventional transfusion(control group,typically matched only for D antigen),and 83 received transfusion based on extended Rh antigen matching(Rh-matched or Rh-reduced-antigen,study group).The hemoglobin(Hb)and hematocrit(HCT)levels,effective infusion rate,Rh antibody positivity rate,and incidence of adverse reactions were compared between the two groups.Results The Rh antigen phenotype distribution revealed CCDee and CcDEe as the most common phenotypes,while CCDEE was the least frequent.No statistically significant differences were observed in the frequencies of the five Rh antigens(C,c,D,E,e)and five genes(C,c,D,E,e)between hospitalized patients and the healthy cohorts(donors and healthy subjects)(all P＞0.05).Compared to the control group,the study group received a significantly lower average volume of red blood cells and exhibited a significantly higher effective infusion rate.The incidence of Rh alloantibodies and transfusion reactions was significantly lower in the study group(all P＜0.05).Post-transfusion Hb and HCT levels increased significantly in both groups compared to pre-treatment levels(P＜0.05),with significantly greater improvements observed in the study group compared to the control group(P＜0.05).Conclusion Rh blood group antigen phenotyping followed by Rh-matched or Rh-reduced-antigen transfusion effectively reduces the incidence of unexpected Rh alloantibodies,improves transfusion efficacy,and enhances patient safety.关键词
输血/Rh血型系统/血型抗原/输血不良反应Key words
Blood transfusion/Rh blood group system/Blood group antigens/Transfusion reaction
