血型是(shi)(shi)(shi)指血(xue)液(ye)成分(包括紅細胞(bao)、白細胞(bao)、血(xue)小板)表面的抗原類型(xing)(xing)。通常所(suo)說的血(xue)型(xing)(xing)是(shi)(shi)(shi)指紅細胞(bao)膜上特異(yi)性抗原類型(xing)(xing),而與(yu)臨床關系最密(mi)切,人(ren)們所(suo)熟知的是(shi)(shi)(shi)紅細胞(bao)ABO血(xue)型(xing)(xing)系統及Rh血(xue)型(xing)(xing)系統。
ABO血型
ABO血型(xing)(xing)(xing)是(shi)根據(ju)紅(hong)細胞(bao)膜上是(shi)否存在抗(kang)(kang)(kang)原(yuan)(yuan)A與抗(kang)(kang)(kang)原(yuan)(yuan)B而將血液分成4種血型(xing)(xing)(xing)。紅(hong)細胞(bao)上僅有(you)抗(kang)(kang)(kang)原(yuan)(yuan)A為(wei)A型(xing)(xing)(xing),只(zhi)有(you)抗(kang)(kang)(kang)原(yuan)(yuan)B為(wei)B型(xing)(xing)(xing),若同(tong)時存在A和B抗(kang)(kang)(kang)原(yuan)(yuan)則為(wei)AB型(xing)(xing)(xing),這兩種抗(kang)(kang)(kang)原(yuan)(yuan)俱無的為(wei)O型(xing)(xing)(xing)。不(bu)同(tong)血型(xing)(xing)(xing)的人血清中(zhong)含有(you)不(bu)同(tong)的抗(kang)(kang)(kang)體(ti),但(dan)不(bu)含有(you)對抗(kang)(kang)(kang)自身紅(hong)細胞(bao)抗(kang)(kang)(kang)原(yuan)(yuan)的抗(kang)(kang)(kang)體(ti)。如:在A型(xing)(xing)(xing)血血清中(zhong)只(zhi)含有(you)抗(kang)(kang)(kang)B抗(kang)(kang)(kang)體(ti)。我國各族人民中(zhong)A型(xing)(xing)(xing)、B型(xing)(xing)(xing)及O型(xing)(xing)(xing)血各占(zhan)(zhan)約(yue)30%,AB型(xing)(xing)(xing)僅占(zhan)(zhan)10%左右。
Rh血型
人(ren)(ren)的(de)紅(hong)(hong)(hong)細(xi)胞上具有(you)(you)與恒(heng)河(he)猴同樣的(de)抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan)稱(cheng)(cheng)為Rh陽性(xing)血(xue)型(xing),不(bu)含有(you)(you)此種(zhong)抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan)則(ze)稱(cheng)(cheng)為Rh陰(yin)性(xing)血(xue)型(xing)。在我國漢族和(he)大部分少(shao)數民(min)族的(de)人(ren)(ren)民(min)中(zhong),Rh陽性(xing)血(xue)型(xing)約占99%,Rh陰(yin)性(xing)的(de)人(ren)(ren)僅(jin)占1%左(zuo)右(you)。Rh血(xue)型(xing)系統是(shi)紅(hong)(hong)(hong)細(xi)胞血(xue)型(xing)中(zhong)最復雜的(de)一種(zhong),已發現(xian)40余種(zhong)Rh抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan),其中(zhong)D抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan)抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan)性(xing)最強(qiang),因此通常(chang)將(jiang)紅(hong)(hong)(hong)細(xi)胞上含有(you)(you)D抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan)稱(cheng)(cheng)為Rh陽性(xing),而紅(hong)(hong)(hong)細(xi)胞上缺乏D抗(kang)(kang)原(yuan)(yuan)(yuan)(yuan)(yuan)的(de)稱(cheng)(cheng)為Rh陰(yin)性(xing)。
稀有血型
稀(xi)有血(xue)型(xing)(xing)(xing)就是一(yi)(yi)種少見或罕見的(de)血(xue)型(xing)(xing)(xing)。這種血(xue)型(xing)(xing)(xing)不(bu)僅在ABO血(xue)型(xing)(xing)(xing)系(xi)(xi)(xi)統中存(cun)在,而且在稀(xi)有血(xue)型(xing)(xing)(xing)系(xi)(xi)(xi)統中也還存(cun)在一(yi)(yi)些更為(wei)罕見的(de)血(xue)型(xing)(xing)(xing)。隨著血(xue)型(xing)(xing)(xing)血(xue)清(qing)學的(de)深入研(yan)究,科學家們已將(jiang)所發現的(de)稀(xi)有血(xue)型(xing)(xing)(xing),分別建立(li)起的(de)稀(xi)有血(xue)型(xing)(xing)(xing)系(xi)(xi)(xi)統,如(ru)RH、MNSSU、P、KELL、KIDD、LUTHERAN、DEIGO、LEWIS、DUFFY以及(ji)其他一(yi)(yi)系(xi)(xi)(xi)列(lie)稀(xi)有血(xue)型(xing)(xing)(xing)系(xi)(xi)(xi)統。
還有(you)一種(zhong)叫孟買型(xing)的稀有(you)血型(xing)系(xi)統,在(zai)(zai)(zai)這種(zhong)血型(xing)的紅細胞(bao)上,沒(mei)有(you)A、B和H抗(kang)原,但在(zai)(zai)(zai)血清中(zhong)卻同時存在(zai)(zai)(zai)A、B和抗(kang)H三種(zhong)抗(kang)體。
在(zai)稀(xi)有血(xue)(xue)型(xing)系統(tong)(tong)中(zhong),除RH血(xue)(xue)型(xing)系統(tong)(tong)外,其他(ta)各(ge)血(xue)(xue)型(xing)人數(shu)在(zai)總人口中(zhong)所占比例(li)非(fei)常小。因(yin)此,它(ta)們在(zai)實際的(de)(de)臨床上遠(yuan)沒有ABO及RH血(xue)(xue)型(xing)系統(tong)(tong)重要,但是,就(jiu)其具(ju)體(ti)來(lai)說(shuo),如用血(xue)(xue)不(bu)當,有些抗體(ti)仍可出現(xian)致(zhi)命(ming)的(de)(de)惡果。 隨(sui)著社會的(de)(de)進(jin)步,人民(min)生活水(shui)平的(de)(de)提高(gao),開展稀(xi)有血(xue)(xue)型(xing)的(de)(de)檢測(ce),建立完整的(de)(de)稀(xi)有血(xue)(xue)型(xing)檔案,對于保障廣大(da)群眾的(de)(de)身體(ti)健康(kang)和(he)適應我國改革開放形勢的(de)(de)需(xu)要,都具(ju)有深遠(yuan)的(de)(de)意義。
基本上(shang),O型(xing)(xing)(xing)是(shi)世(shi)界上(shang)最常(chang)見的血(xue)型(xing)(xing)(xing)。但在某些(xie)地方,如挪威,A型(xing)(xing)(xing)血(xue)型(xing)(xing)(xing)的人較(jiao)多(duo)。A型(xing)(xing)(xing)抗原一般比(bi)B型(xing)(xing)(xing)抗原較(jiao)常(chang)見。AB 型(xing)(xing)(xing)血(xue)型(xing)(xing)(xing)因為要同時有A及(ji)B抗原,故此亦(yi)是(shi)ABO血(xue)型(xing)(xing)(xing)中最少(shao)的。ABO血(xue)型(xing)(xing)(xing)分布跟地區及(ji)種族有關。
應用價值
血(xue)(xue)(xue)型不僅在(zai)(zai)輸(shu)血(xue)(xue)(xue)上有(you)(you)重要(yao)意義,而且在(zai)(zai)人種學(xue)(xue)、遺(yi)傳學(xue)(xue)、法醫學(xue)(xue)、移植(zhi)免疫(yi)、疾病(bing)(bing)(bing)抵抗力(或(huo)易(yi)感性)等方面都有(you)(you)應(ying)用(yong)價(jia)值,在(zai)(zai)輸(shu)血(xue)(xue)(xue)前,一定要(yao)檢查病(bing)(bing)(bing)人(受血(xue)(xue)(xue)者)和輸(shu)血(xue)(xue)(xue)人(供血(xue)(xue)(xue)者)的(de)血(xue)(xue)(xue)型,并且要(yao)進行交叉配血(xue)(xue)(xue)試驗。在(zai)(zai)臨床醫學(xue)(xue)中,除輸(shu)血(xue)(xue)(xue)、移植(zhi)免疫(yi)外,對新生兒溶(rong)(rong)血(xue)(xue)(xue)病(bing)(bing)(bing)、自身免疫(yi)性溶(rong)(rong)血(xue)(xue)(xue)性貧血(xue)(xue)(xue)特異性抗體的(de)檢查,也都需要(yao)血(xue)(xue)(xue)型知識和有(you)(you)關(guan)技術(shu)。
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