RhD抗原变异型同种免疫反应研究

The study of isoimmunity of RhD antigenic variant

目的:研究RhD抗原变异型同种免疫反应。方法:采用微柱凝胶卡方法检测2015-07-2016-06江夏区42 940例本地居民RhD抗原;应用不同厂家RhD抗原试剂对初筛RhD阴性进行RhD阴性确认;使用PCR-SSP法对初筛RhD阴性的样本行RhD基因分型应用抗人球蛋白试验检测初筛RhD阴性样本中的弱D;用吸收放散试验检测初筛RhD阴性样本中的Del;对初筛RhD阴性样本进行不规则抗体筛查和抗体特异性鉴定。结果:在42 940例中共检出179例RhD阴性;在179例初筛RhD阴性中使用血清学方法检出弱D 2例、Del 15例,应用PCR-SSP方法检出弱D 5例、D-CE(2-9)-D融合基因型12例、Del型40例;12例RhD-CE(2-9)-D中有2例产检出抗D抗体;5例弱D未检出抗D抗体;Ddel型人群中未检出抗体。结论:不同RhD的变异型对D抗原有不同的免疫反应;建立不同的输血策略保障输血安全。

Objective：To research the iso-immunization reaction of RhD variant.Method：Use microcolumn gel card to detected RhD antigen about 42 940 resident in Jiangxia District from July 2015 to June 2016;The RhD negative samples were confirmed in the preliminary screening RhD negative samples by different RhD reagent.RhD genetic type was performed in the preliminary screening RhD negative samples by PCR-SSP.The weak D in the preliminary screening RhD negative samples were detective by indirect antiglobulin test.The Del in the preliminary screening RhD negative samples were found out by absorption-elution test.Irregular antibody screening and antibody specificity identification were performed in preliminary screening RhD negative samples.Result：In 42 940 resident 179persons were RhD negative weak D 2persons,Del 15 persons were checked out in 179 persons preliminary screening RhD negative samples by serological examination.Weak D 5persons,D-CE（2-9）-D fusion genetic typle 12 persons,Del type 40 persons be inspected by PCR-SSP.D antibody 2persons were checked out in 12person＇s RhD-CE（2-9）-D.Conclusion：Different RhD antigenic variant have different immunization.The establishment different transfusion strategies guarantee blood transfusion safety.