因妊娠产生抗-D的Rh部分D型基因分析——附3例报告  

Three gene case analysis on the partial RhD variants producing anti-D antibody due to pregnancy

作　　者：朱于莉 胡彬 韩斌 冯智慧 葛东梅[2] ZHU Yuli;HUBin;HAN Bin;FENG Zhihui;GE Dongmei(QingDao Blood Center,Qingdao 266071,China;The affiliated hospital of Qingdao University)

机构地区：[1]青岛市中心血站输血研究所,青岛山东266071 [2]青岛大学附属医院输血科

出　　处：《中国输血杂志》2018年第10期1139-1142,共4页Chinese Journal of Blood Transfusion

基　　金：青岛市市南区科技发展资金项目(2015-6-021-YY)

摘　　要：目的研究3例因妊娠产生抗-DRh部分D型的RHD基因。方法采用间接抗球蛋白试验(IAT)进行RhD确证试验和抗体鉴定试验,采用序列特异性引物聚合酶链反应(PCR-SSP)技术和PCR直接测序方法对RHD进行基因分型。结果通过血清学试验初步确定3例标本为RhD变异型,同时均产生了抗-D;PCR-SSP试验检测标本1和标本2为3-6外显子缺失的RHDⅥtypeⅢ型;PCR测序确定标本3为697G>ARHDVa3型。结论Rh部分D型在输血或妊娠等免疫刺激后,也存在产生抗体的可能性,以RHDⅥtypeⅢ型多见,在临床输血和新生儿溶血病的预防和诊断过程中需加以注意。Objective To analyze 3 cases where partial Rh D variant produced anti-D antibody due to pregnancy. Methods Using the indirect antiglobulin test( IAT) to confirm the Rh D phenotype and identify the abnormal antibody. RHD genotyping of these 3 cases was performed by polymerase chain reaction sequence-specific primer( PCR-SSP) and PCR direct sequencing methods. Results By serological tests,3 samples were identified as Rh D variants,and they all produced anti-D antibody. By PCR-SSP test,sample 1 and sample 2 were RHD Ⅵ type Ⅲ,where RHD exon 3—6 were deleted. PCR sequencing results confirmed that sample 3 was RHD Va 3( 697 G>A). Conclusion Partial Rh D variant may produce anti-D antibodies after immunostimulation,such as blood transfusion or pregnancy. This is more common with RHD Ⅵ type Ⅲ. This deserves great attention during the prevention and diagnosis of clinical blood transfusion and hemolytic disease of newborns.

关 键 词：RHD基因 部分D 抗-D RHD Ⅵ type Ⅲ型 RHD VA 3型 

分 类 号：R457.11[医药卫生—治疗学]