罕见类孟买血型的血清学特点和基因型及其输血选择

Serological characteristics,genotypes and transfusion selection of rare para-Bombay phenotype

类孟买血型是孟买血型的亚型,是一种较为罕见的血型,主要根据红细胞表面是否存在H抗原决定。常规检测时,由于其红细胞上A/B抗原表达极弱,易被误判为O型,常需通过吸收放散试验明确诊断。类孟买血型本质是红细胞上缺乏H抗原,其发生有遗传和基因突变2种原因。本研究通过对1例前列腺癌老年患者进行血型鉴定,发现其正反定型不相符,采用血型血清学常规试验、吸收放散试验及唾液型物质试验等进行血型初步鉴定,采用基因测序明确该患者血型为类孟买hnew/h9杂合子,交叉配血试验患者与A型和O型悬浮红细胞交叉配血主次侧均相容,为患者缓慢输注A型悬浮红细胞2U后,血红蛋白升高,自行出院。因此,分析类孟买血型标本的血清学特点和基因型,可提高类孟买血型的检出率,为该类患者制订合理的输血方案,保障临床输血安全。

The Para-Bombay phenotype is a subtype of the Bombay phenotype,it is a relatively rare blood type,mainly determined by the pres-ence of H antigen on the surface of red blood cells.During routine testing,due to the extremely weak expression of A/B antigen on its red blood cells,it is easily be misdiagnosed as O type,and it is often necessary to make a clear diagnosis through absorption and release test.The essence of pa-ra-Bombay phenotype is the lack of H antigen on red blood cells,the occurrence of para-Bombay phenotype is caused by heredity and gene mutation.In this study,blood group identification was conducted on an elderly patient with prostate cancer,and it was found that the positive and negative posi-tive identification did not match.Routine blood group serology test,absorption and release test and saliva-type substance test were used for prelimi-nary blood group identification,and gene sequencing was used to confirm that the blood group of the patient was a Bombay hnew/h9 heterozygote.The cross-matching blood test patient was compatible with type A and type O suspended red blood cells in both major and secondary areas.After slowly infusion of type A suspended red blood cells 2 U,the hemoglobin of the patient increased and the patient discharged from the hospital by him-self.Therefore,the analysis of serological characteristics and genotypes of Para-Bombay phenotype samples can improve the detection rate of Para Bombay phenotype,and formulate a reasonable transfusion program for these patients,so as to ensure the safety of clinical transfusion.