北京医学
北京醫學
북경의학
BEIJING MEDICAL JOURNAL
2014年
4期
314-316
,共3页
RhD阴性%抗-D%同种免疫%部分D%DEL
RhD陰性%抗-D%同種免疫%部分D%DEL
RhD음성%항-D%동충면역%부분D%DEL
RhD-negative%Anti-D%Alloimmunization%Partial D%DEL
目的:研究血清学RhD阴性个体的基因多态性与抗-D同种免疫的关系,探讨不同基因型个体的个性化输血策略。方法用盐水法及间接抗人球方法(IAT)确定RHD阴性个体,采用序列特异性引物(SSP-PCR)技术分析样本的RHD基因同时进行抗体筛选和抗体鉴定确定产生抗-D的样本。结果在有免疫史的336例入组者样品中,249例(74.1%)个体完全缺失RhD基因,l68例(20.2%)个体携带RHD1227A等位基因,19例(5.6%)携带RHD-CE(2-9)-D融合基因。抗体鉴定产生IgG抗-D的个体68例,63例(92.6%)完全缺失RhD基因,5例(7.4%)携带RHD-CE(2-9)-D融合基因,携带RHD1227A等位基因未检出产生抗-D的个体。结论血清学确定RhD阴性个体的RHD基因型具有丰富的多态性和不同的遗传学背景。真实RhD阴性和部分D个体有D抗原免疫时存在同种免疫风险,作为受血者应输用阴性血。基因型为RHD1227A患者不会产生抗-D,在输血时可输用阳性血。
目的:研究血清學RhD陰性箇體的基因多態性與抗-D同種免疫的關繫,探討不同基因型箇體的箇性化輸血策略。方法用鹽水法及間接抗人毬方法(IAT)確定RHD陰性箇體,採用序列特異性引物(SSP-PCR)技術分析樣本的RHD基因同時進行抗體篩選和抗體鑒定確定產生抗-D的樣本。結果在有免疫史的336例入組者樣品中,249例(74.1%)箇體完全缺失RhD基因,l68例(20.2%)箇體攜帶RHD1227A等位基因,19例(5.6%)攜帶RHD-CE(2-9)-D融閤基因。抗體鑒定產生IgG抗-D的箇體68例,63例(92.6%)完全缺失RhD基因,5例(7.4%)攜帶RHD-CE(2-9)-D融閤基因,攜帶RHD1227A等位基因未檢齣產生抗-D的箇體。結論血清學確定RhD陰性箇體的RHD基因型具有豐富的多態性和不同的遺傳學揹景。真實RhD陰性和部分D箇體有D抗原免疫時存在同種免疫風險,作為受血者應輸用陰性血。基因型為RHD1227A患者不會產生抗-D,在輸血時可輸用暘性血。
목적:연구혈청학RhD음성개체적기인다태성여항-D동충면역적관계,탐토불동기인형개체적개성화수혈책략。방법용염수법급간접항인구방법(IAT)학정RHD음성개체,채용서렬특이성인물(SSP-PCR)기술분석양본적RHD기인동시진행항체사선화항체감정학정산생항-D적양본。결과재유면역사적336례입조자양품중,249례(74.1%)개체완전결실RhD기인,l68례(20.2%)개체휴대RHD1227A등위기인,19례(5.6%)휴대RHD-CE(2-9)-D융합기인。항체감정산생IgG항-D적개체68례,63례(92.6%)완전결실RhD기인,5례(7.4%)휴대RHD-CE(2-9)-D융합기인,휴대RHD1227A등위기인미검출산생항-D적개체。결론혈청학학정RhD음성개체적RHD기인형구유봉부적다태성화불동적유전학배경。진실RhD음성화부분D개체유D항원면역시존재동충면역풍험,작위수혈자응수용음성혈。기인형위RHD1227A환자불회산생항-D,재수혈시가수용양성혈。
Objective To study the genotypeing of Rh-negative individuals and analyze the relationship between genetic background and alloimmunization of D antigen. The transfusion strategies for Rh-negative recipient were explored. Methods Routine serologic tests were used for Rh phenotype and antibody identification. PCR-SSP based methods were used for genotyping of these samples. Results Among the 336 samples, 249 cases were real Rh-negative (74.1%), 168 cases were DEL RhD 1227A(20.2%), 19cases were RHD-CE(2-9)-D(5.6%). By antibody identification, 68 cases were found tp have anti-D. Among the 68 cases, 63 cases were real Rh-negative (92.6%), 5 cases were RHD-CE (2-9)-D (7.4%), none of RhD1227A. Conclusion RhD genetic polymorphism do exists in RhD-negative individuals. Real RhD-negative and partial D have potential risks of alloimmunization to the D antigen. Patients who are RhD-negative and partial D should be transfused with Rh-negative blood. The RHD1227A recipients can be transfused with RhD-positive blood.