西安地区Rh阴性献血者抗原分布及D变异型分子机制的研究

Investigation of Rh phenotypes in RhD negative blood donors and the molecular mechanism of RhD variants in Xi'an blood donors

目的研究西安地区Rh阴性献血者中抗原分布和D变异型的分子机制。方法对初筛为RhD阴性的无偿献血者,采用盐水法鉴定Rh C/c/E/e抗原,采用间接抗球蛋白法(IAT)进行阴性确认。对D变异型采用商用试剂盒进行基因分型,并对特殊标本的RHD基因的10个外显子序列进行测序分析。结果在1 944例初筛阴性标本中,ccee 1 096例(56. 38%),Ccee 554例(28. 50%);阴性确认试验阴性1 865例(95. 94%),阴性确认试验阳性的D变异型79例(4. 06%)。在D变异型中,cc Ee表型35例(44. 30%),Cc Ee表型20例(25. 32%);基因分型检出55例(69. 62%)弱D 15,11例(13. 92%) DⅥⅢ,5例(6. 32%) Del(1227A),3例(3. 79%) Dva(Hus),DBT-1、弱D 33、DLO和RHD*845A/1227A各1例,发现1例新的等位基因RHD*1252G。结论通过对西安地区Rh阴性献血者抗原分布及D变异型分子机制的研究,可以了解本地区Rh抗原分布特点,发现特殊的RHD基因型,对指导临床输血,保障输血安全工作具有重要的作用。

Objective To investigate the Rh phenotypes in RhD-negative blood donors and the molecular mechanism of RhD variants in Xi’an blood donors. Methods Rh blood group C,c,E and e antigen were tested by the saline method.RhD-negative samples were tested by the indirect antiglobulin test(IAT);RhD variants were tested with commercial test kits and special RhD variants were sequenced to identify the changes of in the 10 RHD exons. Results Among 1 944 RhD negative blood donors,1 096 cases(56. 38%) were ccee,554 cases(28. 50%) were Ccee;In the indirect antiglobulin test,1865 cases(95. 94%) were negative,79 cases(4. 06%) were positive. Out of the 79 RhD variants,35 cases(44. 30%) were cc Ee and 20 cases(25. 32%) were Cc Ee. In genotyping,there were 55(69. 62%) weak D 15,11(13. 92%) DⅥ-Ⅲ,5(6. 32%) Del(1227 A,3(3. 79%) Dva(Hus),1 DBT-1,1weak D 33,1 DLO,1 RHD*845A/1227 A and a novel mutation of weak D allele RHD*1252G. Conclusion The investigation of Rh phenotypes in RhD negative blood donors and the molecular mechanism of RhD variants plays an important role in understanding the distribution frequency of Rh phenotypes,discovering unique RHD genotypes,offering guidelines in clinical transfusion and ensuring the safety of clinical transfusion.