PCR技术在母婴ABO血型不合早期诊断中的临床应用探讨

The PCR Technology in the Early Diagnosis of Feto-Maternal ABO Blood Incompatibility

目的建立一种利用孕妇血浆中游离DNA直接检测胎儿ABO血型,用于母婴ABO血型不合的无创性产前诊断方法。方法首先检测孕妇血浆中的抗A(B)IgG抗体,然后利用硅胶膜柱提取的方法从60例13～37w(IgG≥1∶64)可疑母婴ABO血型不合的孕妇血浆中提取胎儿DNA,采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法检测胎儿ABO血型,最后取婴儿脐血进行血清学证实。结果 60例标本中,检出51例,检出率85.0%,出生后血清学证实47例诊断正确,诊断正确率92.16%。结论 PCR技术利用孕妇血浆中游离DNA检测胎儿ABO血型可行,结果可靠,对诊断和预防母婴ABO血型不合所致溶血病的发生具有重要意义。

Objective To establish a method for non-invasive prenatal diagnosis of feto-maternal ABO blood type incompatibility and to use fetal DNA in maternal plasma to measure ABO blood type of a fetus. Methods Firstly,IgG was detected in pregnant woman plasma, and DNA was extracted from 60 maternal plasma samples （pregnant week.. 13-37w, IgG≥1 ： 64）and the fetal ABO blood types were assayed by means of PCR and restriction fragment length polymorphism（PCR-RFLP）. Serum analysis of baby umbilical cord blood was used to confirm the PCR results. Results Among the 60 specimens,51 cases were detected positive and rate of sensitivity was 85.0%, 47 cases were confirmed accurate through serological measure of fetus blood after birth and rate of accuracy was 92. 16% . Conclusion Using PCR technology is feasible to measure ABO blood type with fetal DNA in maternal plasma, the result is reliable. This is of important significance for prenatal diagnossis and prevention of hemolytic diseases of newborns.