北京地区献血人群Duffy血型表型筛查及稀有血型库的建立

Screening of Duffy blood group phenotype in Beijing blood donors and establishment of a rare blood bank

目的调查Duffy血型表型在北京地区的分布频率,将筛选出的稀有血型红细胞甘油化冷冻保存,并建立稀有血型献血者档案资料,解决Duffy稀有血型患者输血难题。方法收集北京地区无血源关系健康汉族献血者的血液标本1 752份,少数民族献血者标本274份,外籍献血者标本137份,利用微柱凝胶法鉴定Duffy血型表型,PCRSSP检测Duffy血型基因,并随机选择17例做Duffy血型基因编码区域序列测定,以检测表现型与基因型符合性。结果1 752名汉族献血者,274名少数民族献血者,137名外籍献血者的Duffy血型各表型分布分别为:Fy(a+b-)表型1 530例(87.33%)、227例(82.85%)、83例(60.58%),Fy(a+b+)表型213例(12.16%)、42例(15.33%)、32例(23.36%),Fy(a-b+)表型9例(0.51%)、5例(1.82%)、20例(14.60%),Fy(a-b-)表型0、0、2例(1.46%)。FYA基因频率分别为93.41、90.51、72.26,FYB基因频率分别为6.59、9.49、26.28,FY基因频率0、0、1.46。汉族与少数民族献血者,中国与外籍献血者表型频率比较,差异均具有统计学意义(P<0.05)。17例FY基因编码序列部分测序结果除2例Fy(a-b-)由于存在FYB基因外,其余标本与血清学、PCR-SSP法均符合。FYA与FYB基因的不同在于FY基因编码区域第131位核苷酸碱基为A或G。结论北京地区汉族献血者Fya阴性表型频率与国内报道相似,而少数民族及外籍献血者较高,在北京地区建立Fya阴性稀有血型供者库,以便解决稀有血型患者紧急输血问题,对提高输血安全具有重要意义。

Objective To investigate the distribution frequencies of Duffy blood group phenotype in Beijing, to preserve rare blood cells by glyeerolization, to create a rare blood donor archive, and to establish a rare blood red cell bank for trans- fusion. Method Blood samples from unrelated healthy Han blood donors （1 752 cases）, ethnic minority （274 cases） and foreign nationality （ 137 cases） were tested for phenotype by using microcolumn gel Coombs card. The antigens genes were detected by PCR-SSP. 17 cases DNA samples were studied by direct DNA sequencing. Result The Duffy blood group phe- notypic distribution in 1 752 cases of Hart blood donors, 274 cases of minority blood donors, 137 cases of foreign nationality were Fy（a＋b-） 1530 （87.33%）, 227 （82.85%）, 83 （60.58%）, Fy（a＋b＋ ）213 （12. 16%）, 42 （15.33%）, 32 （23.36%）, Fy（a-b＋）9 （0.51%）, 5 （1.82%）, 20 （14.60%）, Fy（a-b-） 0, 0, 2 （1.46%）, respectively. The gene frequency of Duffy blood types were FYA = 93.41, 90. 51, 72. 26, FYB = 6.59, 9.49, 26. 28, and FY = 0, 0, 1.46, respectively. When compared with the Han population and the minority, the phenotypic frequency differences in Chinese and foreign nationality were statistically significant （P 〈 0. 05 ）. The 17 DNA samples from direct sequencing were consistent with serology and PCR-SSP except for two Fy（ a - b - ） due to the presence of the FYB gene. FYA/FYB polymorphism is deter- mined by a ~A nueleotide substitution at position 131. Conclusion The Fya negative phenotype frequency Han blood do- nors in Beijing was similar to that in other regions, but has a higher frequency in ethnic minorities and foreign nationalities. The establishment of a Fy^a negative blood donors bank in Beijing is of great significance to improve the safety of blood transfusion and to resolve emergency blood transfusion in patients with rare blood type.