1例B亚型的血型鉴定及其输血策略探究

Identification of a B subgroup and its transfusion strategy

目的:研究1例正反定型不对照的B亚型患者的血清学和分子生物学特征。方法:取患者的静脉血进行正反定型、吸收放散实验、不规则抗体筛查及唾液物质检测等一系列血清学检验,并通过PCR-SSP方法基因分型,最终经DNA测序第6和第7外显子明确亚型种类。结果:血清学检测提示为弱B亚型,PCR-SSP分型为BO1,DNA测序显示与B101序列相比发生nt695位T/C点突变,232位亮氨酸突变为脯氨酸(L232P),国际命名为Bw11亚型。据此结果指导临床用血。结论:检测到1例Bw11亚型,加强围术期血液管理,减少血液丢失及异体血输入,为临床安全用血提供相应的经验参考。

Objective： To study the serological and molecular biological characteristics of a patient with disparity for ABO blood group detection in serology.Methods： Standard serological techniques were performed to analyze erythrocyte phenotype of the patient.The B subgroup were genotyped by polymerase chain reaction-sequence specific primer（PCR-SSP）,and screened by DNA sequencing at the exons 6 and 7.Results： The patient was identified as weak B phenotype by serological technology.The result of genetyping was BO1,and the B allele was observed a missense mutation（695 T to C） at the exon 7 which resulted in an amino acid substitution（L232P） compared with B101.These results were very valuable for clinical blood transfusion.Conclusion： Bw11 allele is detected in a Chinese Han patient.Improving the peri-operative management of blood using to decrease blood losing transfusion of allogeneic blood is a theoretical basis for safety of blood transfusion.