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Grupos e tipos sanguíneos

ABO e Rh são ambos tipos de antígenos encontrados na superfície das hemácias. Existem muitos outros tipos, mas estes são os mais importantes.

Em resumo

  • Your blood group is determined by antigens on your red blood cells.

  • ABO and rhesus are the most important blood group systems.

  • Blood groups are identified by testing a blood sample.

  • Knowing your blood group is important for transfusions and pregnancy.

  • If you are pregnant and rhesus negative, your baby may need monitoring.

  • Donating blood is an easy way to find out your blood group.

The main reasons to know your blood group are if you need to have a blood transfusion or if you are pregnant.

What is a blood group?

Red blood cells (erythrocytes) have certain proteins on their surface, called antigens. Also, your plasma contains antibodies which will attack certain antigens if they are present.

ABO e Rh são ambos tipos de antígenos encontrados na superfície das hemácias. Existem muitos outros tipos, mas estes são os mais importantes.

ABO blood types

These were the first type discovered.

  • If you have type A antigens on the surface of your red blood cells, you also have anti-B antibodies in your plasma.

  • If you have type B antigens on the surface of your red blood cells, you also have anti-A antibodies in your plasma.

  • If you have type A and type B antigens on the surface of your red blood cells, you do not have antibodies to A or B antigens in your plasma.

  • If you have neither type A nor type B antigens on the surface of your red blood cells, you have anti-A and anti-B antibodies in your plasma.

It is not known what the functions of the A and B antigens are. People who don't have either (blood group O) are still just as healthy. There is some evidence that people of different blood groups may be more or less susceptible to certain diseases - for example, blood clots in the blood vessels (thromboembolism) and malária. There is no evidence that people with different blood groups should follow different diets.

Rhesus types

Most people are 'rhesus positive'. This means they have rhesus antigens on their red blood cells. But, about 3 in 20 people do not have rhesus antibodies and are said to be 'rhesus negative'.

Blood group names

Your blood group depends on which antigens occur on the surface of your red blood cells. Your genetic make-up, which you inherit from your parents, determines which antigens are present on your red blood cells. Your blood group is said to be:

  • A+ (A positive) if you have A antigens and rhesus antigens.

  • A− (A negative) if you have A antigens but don't have rhesus antigens.

  • B+ (B positive) if you have B antigens and rhesus antigens.

  • B− (B negative) if you have B antigens but don't have rhesus antigens.

  • AB+ (AB positive) if you have A antigens, B antigens and rhesus antigens.

  • AB− (AB negative) if you have A antigens and B antigens but don't have rhesus antigens. This is the rarest blood group in the UK.

  • O+ (O positive) if you have neither A nor B antigens but you do have rhesus antigens. This is the commonest blood group in the UK.

  • O− (O negative) if you don't have A, B or rhesus antigens.

Other blood types

There are many other types of antigens which may occur on the surface of red blood cells. However, most are classed as 'minor' and are not as important as ABO and rhesus.

How is blood group testing done?

Basically, a sample of your blood is mixed with different samples of plasma known to contain different antibodies. For example, if plasma which contains anti-A antibodies makes the red cells in your blood (erythrocytes) clump together, you have A antigens on your blood cells. Or, if plasma which contains rhesus antibodies makes the red cells in your blood clump together, you have rhesus antigens on your blood cells.

By doing a series of such tests it is possible to determine what antigens are on your red blood cells and therefore determine your blood group. Routine blood grouping checks for your ABO and rhesus status. Other red cell antigens are tested for in certain other situations.

Blood transfusions and cross-matching

If you have a blood transfusion, it is vital that the blood you receive is well matched (compatible) with your own. For example, if you receive blood from a person who is A positive and you are B positive then the anti-A antibodies in your plasma will attack the red blood cells (erythrocytes) of the donated blood.

This causes the red cells of the donated blood to clump together. This can cause a serious or even fatal reaction in your body. Therefore, before a blood transfusion is done, your blood group is tested. Then a donor bag of blood is selected with the same ABO and rhesus blood group as yourself.

Then, to make sure there is no incompatibility, a small sample of your blood is mixed with a small sample of the donor blood. After a short time the mixed blood is looked at under a microscope to see if there has been any clumping of blood. If there is no clumping, then it is safe to transfuse the blood.

Blood groups and pregnancy

A blood group test is always done on pregnant women. If the mother is rhesus negative and the unborn baby is rhesus positive (inherited from a rhesus positive father) then the mother's immune system may produce anti-rhesus antibodies.

These may attack and destroy the baby's blood cells. This is rarely a problem in a first pregnancy. However, without treatment, this can become a serious problem in subsequent pregnancies, as the mother's immune system will be 'sensitised' after the first pregnancy. This is called rhesus disease, but it is rare nowadays as it can be prevented with injections of a medicine called anti-D immunoglobulin.

Donating blood

Giving blood is simple and saves lives. The blood transfusion service needs people of all blood groups to donate blood, but especially if you have one of the rarer blood groups. By donating blood, you will find out what blood group you are.

Escolhas do paciente para Exames de sangue

Hiponatremia

Exames e investigações

Hiponatremia

Hyponatraemia is a low level of sodium in the blood. Sodium levels in the blood have to be tightly controlled. Various chemical messengers (hormones) and organs are involved in this process. For example, hormones involved include antidiuretic hormone and cortisol, and organs involved include the brain and kidneys. There is a very close relationship between body sodium and body fluid levels.

por Dra. Hayley Willacy, FRCGP

Testes de função da tireoide

Exames e investigações

Testes de função da tireoide

Os testes de função da tireoide são exames de sangue que ajudam a verificar o funcionamento da sua glândula tireoide. Eles são usados principalmente para detectar uma glândula tireoide hipoativa (hipotireoidismo) e uma glândula tireoide hiperativa (hipertireoidismo). Muitas informações básicas sobre a glândula tireoide podem ser encontradas no folheto separado chamado Problemas da Tireoide (incluindo também as Glândulas Paratireoides). Este folheto tratará apenas do exame de sangue que mede como sua tireoide está funcionando, não das doenças específicas, como a doença de Graves, que afetam a tireoide. Nota: as informações abaixo são apenas um guia geral. Os arranjos e a forma como os testes são realizados podem variar entre diferentes hospitais. Alguém pode fazer seu teste de função da tireoide em um hospital e ele pode dar resultados ligeiramente diferentes de tê-lo medido em outro hospital. É importante interpretar os resultados do seu teste de função da tireoide com o médico que os solicitou - então, se o teste foi solicitado pelo seu clínico geral, ele lhe dará o resultado. Se foi solicitado por um consultor hospitalar, você precisa obter o resultado deles e seu clínico geral não o terá.

por Dr. Toni Hazell, MRCGP

Perguntas frequentes

Why is it important for pregnant women to know their blood group?

A blood group test is always performed on pregnant women. This is particularly important to establish if the mother is rhesus negative. If she is rhesus negative and her unborn baby is rhesus positive (having inherited this from the father), her immune system could produce antibodies that attack and destroy the baby's blood cells. While this is rarely an issue in a first pregnancy, it can become a serious problem in subsequent pregnancies if the mother's immune system gets 'sensitised'. However, this condition, known as rhesus disease, is rare nowadays because it can be prevented with anti-D immunoglobulin injections.

Are there any health differences associated with different blood groups?

While the specific functions of A and B antigens are not fully understood, individuals without either (blood group O) are considered equally healthy. There is some evidence suggesting that people with different blood groups might have varying susceptibility to certain conditions, such as blood clots (thromboembolism) and malaria. However, there is no evidence to support the idea that individuals with different blood groups should follow different diets.

What is 'cross-matching' and why is it essential before a blood transfusion?

Cross-matching is a critical step before a blood transfusion to ensure the donor blood is fully compatible with the recipient's blood. After determining the patient's ABO and rhesus blood group and selecting a matching donor unit, a small sample of the patient's blood is mixed with a small sample of the donor blood. This mixture is then examined under a microscope. If no clumping of blood cells occurs, it indicates that the blood is safe to transfuse. This process prevents severe and potentially fatal reactions that could occur if incompatible blood were transfused.

Besides ABO and rhesus, are there other classifications of blood types?

Yes, there are many other types of antigens that can be found on the surface of red blood cells beyond ABO and rhesus. However, most of these are considered 'minor' and are generally not as critical in routine medical situations like transfusions as the ABO and rhesus systems.

What is the commonest blood group in the UK?

The commonest blood group in the UK is O+ (O positive). This means individuals with this blood group have neither A nor B antigens on their red blood cells but do possess rhesus antigens.

Which is the rarest blood group in the UK?

The rarest blood group in the UK is AB- (AB negative). People with this blood group have both A and B antigens on their red blood cells but do not have rhesus antigens.

How can I find out my blood group?

One way to find out your blood group is by donating blood. The blood transfusion service tests donated blood to determine its type. Alternatively, if you require a blood transfusion or are pregnant, your blood group will be tested as part of the routine medical procedures.

Leitura adicional e referências

  • Lab Tests Online® - UK
  • Dean L; ABO Blood Group. Medical Genetics Summaries. Bethesda (MD): National Center for Biotechnology Information (US); 2012-[updated 2015 Jul 27].

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Imagem do autor

Dra. Rosalyn Adleman, MRCGP

MRCGP

A Dra. Rosalyn Adleman é uma médica do NHS que trabalha no norte de Londres.

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Dr Colin Tidy, MRCGP

Médico Generalista, Autor Médico

MBBS, MRCGP, MRCP (Paediatrics), DCH

Dr Colin Tidy é um médico do NHS, baseado em Oxfordshire.

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