目的：比较分析南京地区部分患者及献血员Rh（Rhesus，恒河猴）血型系统主要抗原表现型分布比例及基因频率，探求Rh血型系统主要抗原配合性输注的可行性方案，并评估其效果，为精准安全输血奠定基础。方法：微柱凝胶法检测2020年1月至2021年5月本院在院患者（93910例）及省血液中心发往本院的献血员红细胞（32872例）共计126782例Rh血型系统D、C、c、E、e抗原，计算Rh抗原表型分布及基因频率，以卡方检验检测率的差异，以Hardy-Weinberg平衡定律评估Rh血型分布是否符合规律。本院输血信息管理系统分别记录并储存患者及献血员Rh血型结果，在交叉配血前选择Rh同型或相容献血员血袋进行配合试验。结果：93910例患者RhD抗原阳性率为99.5%（93453/93910）。126782例Rh血型共检出15种表现型，主要表现型分布为DCCee比例为42.27%(53596/126782)、DCcEe比例为35.70%(45267/126782)、DCcee比例为9.01%(11423/126782)、DccEE比例为7.56%(9587/126782)、DccEe比例为3.81%(4834/126782)，检出较罕见表现型DCCEE共7例。本文检出Rh表现型分布符合Hardy-Weinberg定律。D抗原频率为99.57%，C抗原频率为88.03%，c抗原频率为57.06%，E抗原频率为48.00%，e抗原频率为92.18%；D基因频率为0.9348，C基因频率为0.6548，c基因频率 为0.3452，E基因频率为0.2790，e基因频率为0.7209。单倍体DCe频率最高，为0.6369；其次为DcE，频率为0.2724。患者与献血员主要Rh表现型及基因频率无差异（P＞0.05）。经过27889人次Rh配合性输注，同时期我院Rh血型系统抗体阳性率占比全部抗体阳性率由48.61%（198/408）下降至30.25%（108/357）（P＜0.05）。结论：患者与献血员Rh表现型及基因频率无差异 ,患者ABO同型基础上常规进行Rh配合性输注具备可行性；Rh配合性输注可以明显降低不规则抗体阳性发生率，提高输血效果。
Objective: The distribution ratio and gene frequency of Rh blood group main antigen phenotype in some patients and donors in Nanjing were compared and analyzed to explore the feasibility of Rh blood group system main antigen coordination infusion and evaluate its effect, laying a foundation for accurate and safe blood transfusion. Methods: From January 2020 to May 2021, a total of 126,782 Rh blood group system D, C, c, E and e antigens were detected by microcolumn gel method in 93,910 patients in our hospital and 32,872 red blood cells from blood donors sent to our hospital. The phenotypic distribution and gene frequency of Rh antigen were calculated and the difference of detection rate was determined by Chi-square test. The distribution of Rh blood group was evaluated by Hardy-Weinberg equilibrium law. The blood transfusion information management system of our hospital recorded and stored the Rh blood group results of patients and donors respectively, and selected Rh homogenous or compatible donor blood bags for matching test before cross-matching. Results: The positive rate of RhD antigen in 93910 patients was 99.5% (93453/93910). A total of 15 phenotype were detected in 126782 Rh blood groups. The main phenotype rates for DCCee, DCcEe, DCcee, DccEE, DccEe were 42.27%(53596/126782), 35.70%(45267/126782), 9.01%(11423/126782), 7.56%(9587/126782), 3.81%(4834/126782),respectively, and 7 cases of rare phenotype DCCEE were detected. Rh phenotype distribution conforms to Hardy-Weinberg law. D antigen frequency was 99.57%, C antigen frequency was 88.03%, c antigen frequency was 57.06%, E antigen frequency was 48.00%, e antigen frequency was 92.18%. D gene frequency was 0.9348, C gene frequency was 0.6548, c gene frequency was 0.3452, E gene frequency was 0.2790, e gene frequency was 0.7209. The haploid DCe frequency was 0.6369, and the second is DcE with a frequency of 0.2724. There was no difference in Rh phenotype and gene frequency between patients and donors (P > 0.05). After 27889 Rh infusion times, the positive rate of antibody in Rh blood group system decreased from 48.61% (198/408) to 30.25% (108/357) (P < 0.05). Conclusion: There is no difference in Rh phenotype and gene frequency between patients and donors. It is feasible to perform routine Rh coordinated infusion based on ABO homotype in patients. Rh coordination infusion can significantly reduce the incidence of irregular antibody positive and improve the transfusion effect.