RhD阴性孕妇DEL型的筛查及基因型分析

Screening and genotyping of DEL in RhD negative pregnant women

目的通过对天津滨海新区RhD阴性孕妇进行DEL型筛查及基因型分析,结合不规则抗体鉴定,为RhD阴性围产期妇女提供合理的产前检测。方法收集102例天津滨海新区RhD阴性孕妇外周血标本,应用试管法和微柱凝胶法进行RhD确认,应用吸收放散试验进行DEL型确认,应用RhD血型抗原试剂卡进行RhC、c、E、e表型鉴定,使用PCR-SSP法对确认为RhD阴性的样本进行RHD基因分型检测。结果102例RhD初筛阴性个体中检出DEL RHD 1227A纯合型13例(12.7%),DEL RHD 1227A杂合型2例(2%),其RhC/E抗原分型为Ccee 9例(60%),CCee 3例(20%),CcEe 3例(20%)。全缺失RHD基因型70例(68.6%),RHD-CE(2-9)-D型10例(9.8%),弱D15型5例(4.9%),2例不能用此PCR-SSP方法确定其基因型(2%)。结论本地区RhD阴性孕妇DEL型占有较高比例,血清学检测结合基因分型检测,可准确判定RhD血型,从而指导RhD阴性孕妇预防注射免疫球蛋白和新生儿溶血病的预防。

Objective Del screening and genotype analysis were carried out in RHD negative pregnant women in Binhai New Area of Tianjin,combined with irregular antibody identification,and help to the guide prenatal monitoring of pregnant wowen with negative RhD.Methods All samples were texted by serologic blood grouping texts for their phenotypes and irregular antibodies,Serological blood typing was performed using tube test and microcolumn gel method,D was confirmed by absorption and diffusion test,The genetic typing of RHD samples were identified based on PCR-SSP.Results1102 cases with RhD primary screening-negative,13 cases of DEL RHD 1227A homozygotes(12.7%),2 cases of DEL RHD 1227A Hetero-zygotes(2%).Among them,9 cases were Ccee(60%),3 cases were CCee(20%)and 3cases were CcEe(20%).RHD genetic typing results were 70 cases lacked the whole RHD gene(68.6%),10 cases of RHD-CE(2-9)-D(9.8%),5 cases of weak D15(4.9%),2 cases could not be genotyped by the PCR-SSP method(2%)Conclusion The prevalence of DEL type in RHD negative pregnant women in this area is high.Serological detection combined with genotyping can accurately determine the blood type of RHD,so we can instruct the RHD negative pregnant women to prevent the injection of immunoglobulin and the prevention of hemolytic disease of newborn.