Rh缺失型D（-）（-）血清免疫学和基因分析及在输血中的应用  

Serum immunology and gene analysis of Rh deletion D（-）（-）and application in blood transfusion

作　　者：张秀铮 王守燕 张韦 王静 

机构地区：[1]山东滨州市中心血站,256613

出　　处：《国际输血及血液学杂志》2015年第1期24-27,共4页International Journal of Blood Transfusion and Hematology

摘　　要：目的 通过对1例Rh缺失型D--血型进行检测分析,探讨该血型的临床输血应用价值.方法 选择2010年3月送滨州市中心血站检测血型的1例Rh缺失型D-患者为研究对象.采用血型血清学、流式细胞术分析其血型血清学特点及红细胞膜D抗原变化.采用序列特异性引物-PCR技术检测RHCE基因外显子,并分析其基因变化情况.在本例患者之后,临床急需这一稀有血液时,自体内采集的400 mL Rh缺失型D-成功救治1例同型危重患者.结果 本例患者血型为A型、D-,RhD抗原表达量超出正常个体1倍以上;基因检测定型为D-SH表型,为国内首次报道基因型.采用其血液成功抢救1例同型危重患者,该同型危重患者接受输血后,血红蛋白水平由24 g/L上升至38 g/L.结论 Rh缺失型D--血型血清学较易鉴定,但易漏检.从先证者家系中筛查及动员先证者健康时献血是解决这一罕见血型供血的有效方法.Objective To explore application value of Rh deletion D--in clinical blood transfusion through a case study.Methods In March 2010,one case of Rh deletion D--received by Binzhou Blood Center was included in this study as a research object.The patien＇ s serological characteristics and erythrocyte D antigen variation were analyzed by blood group serology and flow cytometry.RHCE gene exon was detected through PCR-sequence specific primer,and its change was observed.After this patient was recovered,400 mL Rh deletion D--blood was collected for curing a similar critical patient.Results The patient＇s blood type is A and D--,with the RhD expression level twice more than normal.The result of gene detection was D-SH phenotype,which was the first ever report in China.The blood transfusion successfully rescued another critical patient,whose hemoglobin level increased from 24 g/L to 38 g/L after receiving blood transfusion.Conclusions Rh deletion D--blood type is easy to identify but also easy to miss detection.It is an effective method to guarantee the blood supply of this rare blood type by screening the proband and mobilizing them to donor healthy blood.

关 键 词：流式细胞术 基因测定 供血 Rh缺失型D(-)(-)血型 

分 类 号：R457.1[医药卫生—治疗学]