血型是指血(xue)液成(cheng)分(包括(kuo)紅細(xi)(xi)胞(bao)、白細(xi)(xi)胞(bao)、血(xue)小板(ban))表(biao)面(mian)的抗原類(lei)型(xing)(xing)。通(tong)常所說的血(xue)型(xing)(xing)是指紅細(xi)(xi)胞(bao)膜上特(te)異性抗原類(lei)型(xing)(xing),而與臨床關系最(zui)密切,人們所熟知的是紅細(xi)(xi)胞(bao)ABO血(xue)型(xing)(xing)系統(tong)及Rh血(xue)型(xing)(xing)系統(tong)。
ABO血型
ABO血(xue)(xue)型(xing)(xing)是根據紅細胞(bao)膜(mo)上(shang)是否存(cun)在(zai)抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)A與抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)B而將血(xue)(xue)液分(fen)成4種(zhong)血(xue)(xue)型(xing)(xing)。紅細胞(bao)上(shang)僅(jin)有(you)(you)抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)A為(wei)(wei)(wei)A型(xing)(xing),只有(you)(you)抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)B為(wei)(wei)(wei)B型(xing)(xing),若(ruo)同(tong)時存(cun)在(zai)A和B抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)則為(wei)(wei)(wei)AB型(xing)(xing),這兩(liang)種(zhong)抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)俱無的(de)(de)為(wei)(wei)(wei)O型(xing)(xing)。不同(tong)血(xue)(xue)型(xing)(xing)的(de)(de)人(ren)血(xue)(xue)清中(zhong)(zhong)含(han)有(you)(you)不同(tong)的(de)(de)抗(kang)(kang)(kang)體(ti),但(dan)不含(han)有(you)(you)對抗(kang)(kang)(kang)自身紅細胞(bao)抗(kang)(kang)(kang)原(yuan)(yuan)(yuan)的(de)(de)抗(kang)(kang)(kang)體(ti)。如:在(zai)A型(xing)(xing)血(xue)(xue)血(xue)(xue)清中(zhong)(zhong)只含(han)有(you)(you)抗(kang)(kang)(kang)B抗(kang)(kang)(kang)體(ti)。我(wo)國各族人(ren)民中(zhong)(zhong)A型(xing)(xing)、B型(xing)(xing)及O型(xing)(xing)血(xue)(xue)各占約30%,AB型(xing)(xing)僅(jin)占10%左右(you)。
Rh血型
人的紅(hong)(hong)細胞上(shang)具有與恒河(he)猴同樣的抗(kang)原(yuan)(yuan)稱(cheng)為(wei)Rh陽(yang)性血型(xing)(xing)(xing),不含(han)有此(ci)種抗(kang)原(yuan)(yuan)則稱(cheng)為(wei)Rh陰(yin)性血型(xing)(xing)(xing)。在我國(guo)漢族和大部分少(shao)數民族的人民中(zhong),Rh陽(yang)性血型(xing)(xing)(xing)約占(zhan)99%,Rh陰(yin)性的人僅占(zhan)1%左右。Rh血型(xing)(xing)(xing)系統是紅(hong)(hong)細胞血型(xing)(xing)(xing)中(zhong)最復雜的一種,已發現(xian)40余(yu)種Rh抗(kang)原(yuan)(yuan),其(qi)中(zhong)D抗(kang)原(yuan)(yuan)抗(kang)原(yuan)(yuan)性最強,因此(ci)通常將紅(hong)(hong)細胞上(shang)含(han)有D抗(kang)原(yuan)(yuan)稱(cheng)為(wei)Rh陽(yang)性,而(er)紅(hong)(hong)細胞上(shang)缺乏D抗(kang)原(yuan)(yuan)的稱(cheng)為(wei)Rh陰(yin)性。
稀有血型
稀有(you)(you)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)就是一種少見或罕見的(de)(de)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)。這種血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)不(bu)僅在(zai)ABO血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)系(xi)(xi)統中存在(zai),而且在(zai)稀有(you)(you)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)系(xi)(xi)統中也還存在(zai)一些更為罕見的(de)(de)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)。隨著血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)血(xue)(xue)(xue)(xue)(xue)(xue)清學的(de)(de)深入研究(jiu),科學家們已(yi)將所(suo)發現(xian)的(de)(de)稀有(you)(you)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing),分別(bie)建立(li)起的(de)(de)稀有(you)(you)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)系(xi)(xi)統,如RH、MNSSU、P、KELL、KIDD、LUTHERAN、DEIGO、LEWIS、DUFFY以及其他一系(xi)(xi)列稀有(you)(you)血(xue)(xue)(xue)(xue)(xue)(xue)型(xing)(xing)系(xi)(xi)統。
還有(you)(you)一種叫孟買型(xing)的稀有(you)(you)血型(xing)系統,在這種血型(xing)的紅細(xi)胞上,沒有(you)(you)A、B和(he)H抗(kang)原(yuan),但(dan)在血清中卻同(tong)時存在A、B和(he)抗(kang)H三種抗(kang)體。
在稀(xi)(xi)有(you)血(xue)型(xing)(xing)系(xi)(xi)統中,除RH血(xue)型(xing)(xing)系(xi)(xi)統外,其(qi)他(ta)各血(xue)型(xing)(xing)人數在總人口中所占比例非常小。因此,它(ta)們(men)在實際的臨床上(shang)遠沒(mei)有(you)ABO及RH血(xue)型(xing)(xing)系(xi)(xi)統重要(yao),但(dan)是(shi),就其(qi)具體(ti)來說(shuo),如用(yong)血(xue)不當,有(you)些抗體(ti)仍(reng)可出現致(zhi)命的惡(e)果。 隨著社(she)會的進步,人民生活水平的提高,開展稀(xi)(xi)有(you)血(xue)型(xing)(xing)的檢測,建(jian)立(li)完整的稀(xi)(xi)有(you)血(xue)型(xing)(xing)檔(dang)案,對于保障廣大群(qun)眾的身體(ti)健康和適應(ying)我國改革開放(fang)形(xing)勢的需(xu)要(yao),都具有(you)深遠的意義。
基本上,O型(xing)(xing)(xing)(xing)是(shi)世界(jie)上最常見的(de)血(xue)型(xing)(xing)(xing)(xing)。但在(zai)某(mou)些(xie)地方,如挪威(wei),A型(xing)(xing)(xing)(xing)血(xue)型(xing)(xing)(xing)(xing)的(de)人較(jiao)多。A型(xing)(xing)(xing)(xing)抗原(yuan)(yuan)一般比(bi)B型(xing)(xing)(xing)(xing)抗原(yuan)(yuan)較(jiao)常見。AB 型(xing)(xing)(xing)(xing)血(xue)型(xing)(xing)(xing)(xing)因為要同時(shi)有(you)A及(ji)(ji)B抗原(yuan)(yuan),故此亦是(shi)ABO血(xue)型(xing)(xing)(xing)(xing)中最少的(de)。ABO血(xue)型(xing)(xing)(xing)(xing)分布跟地區(qu)及(ji)(ji)種(zhong)族有(you)關(guan)。
應用價值
血(xue)型(xing)不僅在輸(shu)(shu)血(xue)上有(you)重要意義,而且(qie)在人(ren)種學(xue)、遺傳學(xue)、法醫學(xue)、移植免疫、疾病(bing)抵(di)抗(kang)力(或易感性)等方面都有(you)應用價值,在輸(shu)(shu)血(xue)前(qian),一定要檢查病(bing)人(ren)(受(shou)血(xue)者(zhe))和輸(shu)(shu)血(xue)人(ren)(供血(xue)者(zhe))的(de)血(xue)型(xing),并且(qie)要進行交(jiao)叉配血(xue)試驗。在臨床醫學(xue)中,除輸(shu)(shu)血(xue)、移植免疫外,對新生(sheng)兒溶血(xue)病(bing)、自身(shen)免疫性溶血(xue)性貧血(xue)特異性抗(kang)體的(de)檢查,也都需(xu)要血(xue)型(xing)知識和有(you)關技術(shu)。
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