摘要
目的分析疑难血型处理策略,探讨血型基因检测在疑难血型中应用的意义。方法收集本院输血科疑难血型标本44例,采用血清学及血型基因检测方法完成疑难血型的鉴定。结果44例疑难血型中,血清学实验结果提示,异基因造血干细胞移植引起ABO正反定不一致5例,疾病或生理因素造成抗原减弱致ABO正反定不一致9例,抗体减弱致ABO正反定不一致14例,自身冷凝集致ABO正反定不一致6例,蛋白干扰致ABO正反定不一致6例,同种抗体引起ABO正反定不一致3例,RhD变异1例。44例疑难血型中血清学无法排除亚型的疑难血型8例,其中2例未能进行血型基因检测,其余6例血型基因结果提示,3例未有亚型突变基因分别为ABO*O.01.01/ABO*B.01、ABO*A1.02/B.01、ABO*O.01.02/B.01,2例ABO亚型分别为ABO*B.01(with28G)/ABO*O.01.02、ABO*BA.02/ABO*O.01.02,1例Del型为RHD*01EL.32/RHD*17.05。结论对于血清学实验解释不了的结果,可以结合血型基因检测结果综合分析,得出正确的血型,为临床提供可靠的ABO/RhD血型报告,从而保障临床输血安全。
Objective To analyze the processing strategy of difficult blood type and to further explore the significance of blood type gene detection in difficult blood type.Methods 44 difficult blood type samples were selected from Blood Transfusion Department of our hospital,and all blood samples were determined by serological identification and gene detection.Results The detection results of the serological experiments in 44 samples showed as follow:5 cases of ABO discrepancy in forward/reverse typing caused by allogeneic stem transplantation,9 cases of weakened antigen due to the disease or physiological factors,antibodies were diminished in 14 cases which led to ABO discrepancy in forward/reverse typing,self-agglutination in 6 cases,which resulted in ABO discrepancy in forward/reverse typing,6 cases of ABO discrepancy in forward/reverse typing were observed in protein interference,3 cases of ABO positive and negative inconsistency caused by homologous antibodies,and one case of RhD mutation.Among 44 difficult blood groups,8 cases of difficult blood types were not discriminated by serology,and two of them failed to perform blood group gene testing.The results of the blood group genes in the remaining six cases indicated that three cases had no subform mutated genes,and they were ABO*O.01.01/ABO*B.01,ABO*A1.02/B.01,ABO*O.01.02/B.01.Two cases of the ABO subtype were ABO*B.01(with28G)/ABO*O.01.02,ABO*BA.02/ABO*O.01.02.One case of Del type was RHD*01EL.32/RHD*17.05.Conclusion For results that cannot be well explained by serological experiments,we can combine them with the blood type gene test to obtain correct blood types.This approach can provide more reliable ABO/RhD blood group reports for clinical practice and ensure the safety of clinical transfusion.
作者
顾小文
邓之奎
GU Xiaowen;DENG Zhikui(Department of Transfusion,The First Affiliated Hospital of Huaian,Nanjing Medical University,Huaian 223300,China)
出处
《标记免疫分析与临床》
CAS
2024年第8期1522-1528,共7页
Labeled Immunoassays and Clinical Medicine
基金
江苏省输血协会英科新创基金(编号:JS2022029)。
关键词
疑难血型
血型基因
亚型
血清学实验
Difficult blood type
Blood type gene
Hypotype
Serological experiments
