Rh系统D、C、c、E、e抗原配合性输注对肝硬化上消化道出血患者个体化输血治疗的价值

摘要/Abstract

摘要： 目的探讨Rh系统D、C、c、E、e抗原配合性输注在肝硬化上消化道出血(UGIB)患者个体化输血治疗中的价值。方法选择乐山市中医医院2022年3月至2025年2月临床待输血的肝硬化伴UGIB患者100例,随机数字表法分为两组各50例。输血前所有患者均进行血型鉴定和抗体筛查,对照组给予常规检测ABO血型及RhD抗原检测,观察组接受Rh系统D、C、c、E、e抗原检测。比较两组输血治疗有效性及配血成功率、不规则抗体筛查、输血前后血常规指标[红细胞计数(RBC) 、血红蛋白(Hb)、血细胞比容(HCT)]、输血不良反应。结果观察组配血成功率96.00%,高于对照组(80.00%,P<0.05),而两组输血治疗有效性比较(94.00% vs. 86.00%)差异无统计学意义(P>0.05)。观察组不规则抗体阳性率4.00%、Rh血型系统抗体筛查阳性率2.00%,均低于对照组(分别为20.00%、16.00%,P<0.05),而两组双群频率发生率比较(2.00% vs. 10.00%)差异无统计学意义(P>0.05)。输血后,两组RBC、Hb、HCT均较输血前升高,且观察组RBC、Hb、HCT均高于对照组(P<0.05)。两组输血不良反应比较(4.00% vs. 12.00%)差异无统计学意义(P>0.05)。结论 Rh系统D、C、c、E、e抗原配合性输注应用于肝硬化伴UGIB患者个体化输血治疗效果显著,可有效提高配血成功率,降低不规则抗体阳性率,改善血常规指标,且不易增加输血不良反应。

关键词: 肝硬化, 上消化道出血, 个体化输血, Rh血型, 匹配输注

Abstract: Objective To explore the value of compatibility transfusion based on Rh system antigens (D, C, c, E, e) in individualized transfusion therapy for liver cirrhosis patients with upper gastrointestinal bleeding (UGIB). Methods A total of 100 liver cirrhosis patients with UGIB requiring transfusion at Leshan Hospital of Traditional Chinese Medicine from March 2022 to February 2025 were selected and randomly divided into two groups (50 cases each) using a random number table. All patients underwent blood type identification and antibody screening before transfusion. The control group received conventional ABO blood type and RhD antigen testing, while the observation group underwent Rh system D, C, c, E, e antigen testing. Transfusion efficacy, crossmatch success rate, irregular antibody screening results, pre- and post-transfusion blood parameters [red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT)], and transfusion adverse reactions were compared. Results The crossmatch success rate in the observation group (96.00%) was higher than that in the control group (80.00%) (P<0.05), while no significant difference was observed in transfusion efficacy (94.00% vs. 86.00%, P>0.05). The observation group had lower rates of irregular antibody positivity (4.00% vs. 20.00%) and Rh system antibody positivity (2.00% vs. 16.00%) (P<0.05), with no difference in mixed-field reaction frequency (2.00% vs. 10.00%, P>0.05). Post-transfusion RBC, Hb, and HCT levels increased in both groups, with higher values in the observation group (P<0.05). No significant difference was found in transfusion adverse reactions (4.00% vs. 12.00%, P>0.05). Conclusion The application of Rh system D, C, c, E, and e antigen compatibility transfusion in personalized transfusion therapy for patients with cirrhosis and UGIB demonstrates significant efficacy. It effectively improves blood matching success rates, reduces the positive rate of irregular antibodies, enhances routine blood parameters, and does not significantly increase the incidence of adverse transfusion reactions.

Key words: Liver cirrhosis, Upper gastrointestinal bleeding, Individualized transfusion, Rh blood group, Matched transfusion

王笺, 雷建东, 胥诗曼, 吴林军. Rh系统D、C、c、E、e抗原配合性输注对肝硬化上消化道出血患者个体化输血治疗的价值[J]. 肝脏, 2025, 30(8): 1089-1092.

WANG Jian, LEI Jian-dong, XU Shi-man, WU Lin-jun. The value of Rh system D, C, c, E, e antigen-compatible transfusion in individualized transfusion therapy for liver cirrhosis patients with upper gastrointestinal bleeding[J]. Chinese Hepatolgy, 2025, 30(8): 1089-1092.

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