RESUMO
【Objective】 To investigate the profile of Rh blood group antigen in pregnant women and hemolytic disease of the newborn (HDN) in Qingdao area. 【Methods】 10 597 pregnant women admitted in our hospital during October 2016 to February 2020 were selected and the ABO, Rh blood group system antigen (D, C, c, E, e) and the irregular antibody were detected, and positive antibody was further identified. The irregular antibody of Rh blood group in pregnant women was statistically analyzed according to the history of blood transfusion and pregnancy. Twelve HDN cases were studied, and the results of ABO, Rh blood group antigen and irregular antibody, antibody property identification, HDN test and blood routine test were retrospectively analyzed. 【Results】 Among 10 513 cases of Rh-positive pregnant women, the common phenotype was CCee>CcEe>Ccee>ccEE>ccEe; among 84 cases of Rh-negative pregnant wome, the common phenotype was ccee>Ccee> CCee> ccEE>ccEe. The positive rate of irregular antibody was 1.06% (112/10597) in 10 597 pregnant women, of which the Rh antibody was the highest, rated at 56.25% (63/112). For 64 pregnant women with positive antibodies, antibodies against Rh system were different from those against other systems when stratified by the history of blood transfusion (P<0.05) and pregnancy (P<0.05). Twelve neonates were diagnosed with Rh-HDN, with IgG anti-E in 6 cases, IgG anti-D 3, IgG anti-cE 1, IgG anti-C 1and IgG anti-c 1. Among them, 3 were seriously ill and treated with blood exchange. 【Conclusion】 As two-child policy was implemented, the incidence of Rh HDN had increased. ABO, RhD, C, c, E and e matched transfusion should be administered for women at childbearing age. Meanwhile, clinical termination of delivery was recommended for pregnant women, who probably develop Rh-HDN and are with critical situation. Rh phenotype matched fresh blood should be prepared, which has great clinical significance for rescuing newborns.
RESUMO
【Objective】 To establish the multiple regression equation based on R language in order to guide scientific and reasonable blood preparation for clinicians before liver transplantation. 【Methods】 Basic clinical information, including gender, age and disease types, of 183 liver transplant patients were collected, and results of preoperative blood routine(MCV, MCHC, Hct, RBC, Hb and Plt), prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT), fibrinogen(FIB), international normalized ratio(INR) and D dimer and antithrombin Ⅲ(AT Ⅲ), operation time, as well as intraoperative transfusion volume of red blood cells, plasma, cryoprecipitates and platelets were analyzed using R language analysis.The correlation between blood component transfusion volume and analysis factors was calculated by generalized linear function, and the regression equation for predicting blood preparation was obtained by Poisson regression analysis. 【Results】 Intraoperative transfusion rates of RBC, plasma, platelets and cryoprecipitates in liver transplantation patients were 85.79%(8.35±8.78 U), 100%(1 083±742.80 mL), 18.58%(0.26±0.60 treatment dose), and 12.02%(2.49±7.51 U), respectively. According to the analysis factors with good correlation, the prediction equations for the volume of each blood component were as follows: RBC: 3.348+ 1.276×Time-0.02×Hct-0.16×RBC-0.006×Hb, plasma: 6.901+ 0.826 ×Time-0.003×Hb, platelets: -1.275+ 1.866×Time-0.013 Hb+ 0.025×TT, and cryoprecipitates: -7.183+ 2.888×Time + 0.067×MCV+ 0.029×TT. 【Conclusion】 It is of great clinical significance to use R language to carry out multivariate regression analysis and establish the prediction regression equation of blood preparation before liver transplantation, which can provide scientific, reasonable and sufficient blood supply in operation.
RESUMO
【Objective】 To investigate the positive rate of platelet antibody in pregnant women and analyze the related factors. 【Methods】 A total of 620 pregnant women who underwent antenatal examination from March 2017 to July 2018 were screened for platelet antibodies by solid phase agglutination method. The relationship between platelet antibody positive rate and blood transfusion history, reproductive history and ABO blood group were analyzed, and the profile of disease were alsodiscussed. 【Results】 55 out of 620 pregnant women presented positive platelet antibody, with a positive rate of 8.87%.The platelet antibody positive rate of pregnant women with ahistory of blood transfusion (14.13%) was higher than those never transfused before(6.65%), and the platelet antibody positive rate of pregnant women with a childbirth history (10.46%) was higher than those didn′t bear before(3.52%), showing statistically significant differences (P0.05). Pregnant women with positive platelet antibodies mainly suffered from diseases such as placenta pravia, scarred uterus, placental implantation and thrombocytopenia. 【Conclusion】 Blood transfusion history, reproductive history and disease type have certain effects on the positive rate of platelet antibody in pregnant women.Screening platelet antibody in pregnant women is of great significance to prevente and reduce miscarriage during pregnancy and the occurrence of neonatal alloimmune thrombocytopenic purpura(NAITP).