罕见B(A)血型的检测及其安全输血探讨

Rare Blood Group B(A) Detection and Safe Transfusion

本研究探讨稀有B(A)血型的遗传特性、鉴定方法和输血策略。采用血型血清学方法、PCR-SSP方法基因定型和ABO血型第6、7外显子直接测序的方法进行B(A)血型鉴定,并分析该家系的血型遗传特点和分子机制;同时对B(A)型献血者和用血者进行配合性试验和临床输血研究。结果表明,该家系调查发现3例血清学结果正反定型结果不符,均为血清学结果为正定型AB型,反定型B型,ABO基因型为B(A)04/O01型,1袋B(A)型红细胞输注给1例B型患者后临床有轻度的输血反应,B(A)型患者输注O型洗涤红细胞后患者未出现输血反应。结论:对ABO血型血清学正反定型不符的标本,可以用家系调查和分子生物学方法进行辅助验证,B(A)型血液不能给B型或AB型患者输注,B(A)血型患者输血时应采取配合性成分输血或自身输血。

This study was aimed to investigate the genetic characteristics, identification method and transfusion strategy of rare blood type B（A）. The rare blood group B（A） was typed by serological technique, PCR-SSP genotyping and sequencing of exon 6,7 of ABO blood group. The genetic characteristics and molecular mechanism of B（A） blood group were also analyzed. Blood group compatibility test was conducted between blood donors of B （A） and recipients by clinical transfusion. The results showed that both forward and reverse grouping did not match the 3 cases of serological result in their family survey, while all of the 3 cases were grouped as AB blood group by forward grouping, B blood group by reverse grouping with serological result and B（ A）04/001 group were genotyped by ABO genotyping. The patient of B blood group was transfused by 1 bag of washed red blood cells of donor of B （ A ） under closely monitroring, the patient＇s condition changed, and a mild adverse transfusion reaction was appeared. Washed red blood cell of O blood group was transfused into B （A） patient without blood transfusion reaction. It is concluded that the forward ABO serological grouping and reverse ABO serological grouping are not compatible, that may be verified by family survey and molecular biological methods. If in some cases transfusion therapy was applied, and group B（A） can not be transfused to the patient with group B or AB. Thus, transfusion compatibility or autologous transfusion can be adopted to transfuse to the patient from group B （A）.