儿童患者RhD弱阳性变异体的初步分析

Preliminary analysis on RhD variants in children with Rh(D) weak positive phenotypes

目的对RhD弱阳性儿童患者进行RhD变异体检测分析。方法用微柱凝胶血型鉴定卡及盐水试管法进行RhD血型初筛;微柱凝胶抗球法进行弱D确认试验;确认试验RhD弱阳性者进行PCR-SSP及RHD外显子测序分析。结果 RhD初筛阴性46例(0.38%),确认实验检出弱阳性4例(8.7%);4例RhD弱阳性标本经基因检测,1例1227A杂合子(Del型),1例DⅢa型,2例弱D15型。结论 Del型也可能被血清学方法检出;RhD弱阳性患者中抗原数量减少者较多;针对RhD阳性红细胞是否产生需进一步研究。

Objective To detect and analyze Rh D variants in children with Rh D weak positive phenotypes. Methods Rh D blood group was preliminarily screened using micro-column gel blood group identification card and saline test. Weak D confirmatory test was performed using micro-column gel anti-globulin technique. Patients with Rh（ D） weak positive phenotypes were confirmed by PCR-SSP and RHD exon sequencing. Results Rh（ D） preliminary screening was negative in 46 cases,in which 4 cases were detected as weak positive. Of these 4 Rh D weak positive samples,one was 1227 A heterozygote（ D^eltype）,one was DⅢa type and two were weak D15 types. Conclusion Del type in Rh（ D） weak positive variants may be detected by serological methods. The reduction of antigen quantity in Rh（ D） weak positive variants（ D^eltype and weak D15 type） is more frequently detected. It is necessary to follow up with the immune responses in these recipients with the reduction of antigen quantity after transfusion with Rh（ D） positive red blood cells.