Related Investigation Of ABO And Rh Blood Group & Important Significance Of Establishment Of Rh Phenotypic Libraries In Safety Of Blood Transfusion

Objective 1.To survey the distribution law of patients’ ABO and RhD group in Tianjin Binhai New Area, grasp the dynamic state of clinical blood use, and provide the scientific basis for making rational plan of clinical blood use and adjusting inventory blood; 2.to investigate the irregular antibody screening situation before patients’ blood transfusion, analyse and discuss its clinical significance, reduce blood transfusion reaction; 3.to understand the distribution of Rh blood group antigen and phenotype of RhD positive blood donation members, establish the phenotype library of Rh blood group, to ensure clinical blood transfusion safety through the same phenotype transfusion.Methods 1.BIO-RAD automatic blood group blood matching analyzer was applied to conduct the positive and reverse ABO and RhD blood group on 24072 cases of patients hospitalized in Tianjin No.5 Central Hospital during 2014 to 2016, the duplicate detection of the same patients was removed; 2.irregular antibody screening was carried out on the 7728 patients who planned to have blood transfusion and surgery within 2 years. The specimens with positive results were sent to the Tianjin Binhai New Area Tanggu Center Blood Station for antibody specificity identification;3.2382 bags of RhD positive suspended red blood cell samples that Tianjin Binhai New Area Tanggu Center Blood Station provided to the hospital from 2015 to 2016 were randomly selected and then C, c, D, E and e antigen detection was conducted.Rh phenotype of blood donors was determined, and the results were input the computer to create phenotype database of Rh phenotype for clinical application.Results 1.The distribution feature of ABO blood group of patients in Tianjin Binhai New Area was B(32.87%) > O(29.67%) > A(26.81%) > AB(10.65%). ABO gene frequency was as follows: p(A): 0.2089,q(B):0.2452 and r(O):0.5429,r>p>q.The distribution differences of ABO blood group with the people in 0-20 years old group and 21-30 group、31-40 group 、51-60 group were statistically significant(p<0.003),in the others ages group were not statistically significant(p>0.05). The distribution differences of ABO blood group between different genders were not statistically significant(p>0.05). In this study, 148 RhD negative cases were identified,accounting for 0.61% of the total. Besides, the distribution differences of Rh blood type in crowd of different genders and different ABO phenotypes had no statistical significance(p>0.05); 2.Among the 7728 examined patients, there were 39(0.50%)irregular antibody positive cases, 27 cases of allo-antibody, 5 cases of autoantibody, 3cases of mixed antibody, 4 cases of uncertain specificity. The most of them were anti-E, which were deteceted in 15 cases, 38.46%(15/39). Moreover, the irregular antibody detection rate for different genders and patients with history of blood transfusion and history of pregnancy or not was statistically different(P< 0.05); 3.Rh phenotype distribution of 2382 RhD positive blood donators was: CCDee(41.18%)>Cc DEe(34.68%)> Cc Dee(9.87%)>cc DEE(8.77%)>cc DEe(4.20%)>CCDEe(0.76%)> Cc DEE(0.29%)> cc Dee(0.25%)> CCDEE(0.00%). The distribution feature of the positive rates of antigens were e(90.93%)>C(86.78%)>c(58.06%)>E(48.7%).Conclusion 1.The distribution of ABO blood group has obvious regional differences. The ABO blood group distribution of the respondents in the study has typical ABO blood group distribution characteristics of northern people, while the RhD negative frequency is higher than that in Han population; 2. Irregular antibodies is mainly from Rh blood group. Moreover, the detection rate of anti-E is high on the top of irregular antibodies, and much attention should be paid to it. The patients need to receive multiple blood transfusions dectection when they have a history of blood transfusion, pregnancy or a history of short-term. It should be prior to detect the transfusion irregular antibody, and to identify the specificity and nature of the antibody and take appropriate action to deal;3.Among the respondents in the study,the detection negative rate of anti-E is almost 50% of irregular antibodies, followed by c antigen. The risk on the corresponding antibodies due to immunization should not be ignored. The phenotype database of RhD positive blood donors can timely provide the blood matching Rh phenotype and prevent the isoimmunization and hemolytic transfusion reaction caused by Rh blood group system.