新生儿脐血ABO血型鉴定结果质量控制方法探讨

Quality Control for ABO Blood Group Typing of Neonatal Umbilical Cord Blood

本研究探讨一种新生儿脐带血ABO血型鉴定的质量控制方法。采用血型血清学试验对脐血标本作ABO血型鉴定,对不能定出结果的疑难血型采用聚合酶链反应-序列特异性引物(Sequence Specific Primer PCR,PCR-SSP)作进一步确认。结果表明:在76120例脐血ABO血型正定型鉴定中,检出78例ABO血型弱抗原反应和难以判定血型结果的疑难标本(1‰),经复查排除了弱凝集反应30例。检测260例脐血ABO血型反定型,相符血型148例(56.92%),不相符血型112例(43.08%)。PCR-SSP基因分型检测58例中45例血清学表型结果与基因分型结果一致,3例表型结果与基因定型结果不相符,10例正反定型不相符标本,基因分型结果与正定型完全一致。结论:采用红细胞抗原(正定型)方法结合DNA基因分型技术检测新生儿脐带血抗原反应弱、抗体效价低的ABO血型质控效果好,是一种高效、灵敏的质量控制方法,适用于新生儿脐血ABO疑难血型的鉴定。

This study was aimed to investigate a quality control method for ABO typing of neonatal umbilical cord blood（UCB）. The routine serology method was used to identify the ABO type of UCB samples. These samples with questions were further detected by sequence specific primer PCR （PCR-SSP）. The results showed that among total of 76120 UCB samples identified by positive ABO typing, there were 78 samples（1%o） which could not be determined. Of these 78 samples,30 （56.92%） samples with a weak agglutination reaction were excluded by reverse ABO typing. Out of 260 samples in reverse ABO typing, 148 samples were consistent with positive ABO typing, 112 samples （43.08%） were inconsistent with the positive ABO typing. 58 undetermined samples were detected by PCR-SSP. Out of them the genotyping results of 45 samples confirmed the serological typing, the phenotyping results in 3 cases were inconsistent to that of genotyping. 10 cases showed the unconformity between positive and reverse typing, but the genotyping results were fully consistent with the positive typing. In conclusion, positive typing for red cell antigens combined with PCR- SSP is efficient and sensitive for quality control of ABO typing for neonatal UCB.