1例罕见B(A)血型鉴定及其临床安全输血策略初探  

Study on the identification of a case with blood type B(A)and the concerned clinical safety transfusion strategies

作　　者：刘立坤[1] 梁聚友 陈静[1] 姚瑶[1] 郭萌 李晓娜[1] 赵军莉[1] 赵怡然 邢巧玲 潘红娟 李旭桐[1] Liu Likun;Liang Juyou;Chen Jing;Yao Yao;Guo Meng;Li Xiaona;Zhao Junli;Zhao Yiran;Xing Qiaoling;Pan Hongjuan;Li Xutong(Department of Blood Transfusion,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院输血科,河北石家庄050051

出　　处：《临床荟萃》2018年第6期510-514,共5页Clinical Focus

摘　　要：目的鉴定罕见B(A)血型并探讨其临床安全输血策略。方法利用全自动血型分析仪检测ABO血型,发现正反定型不符的一位患者,利用血型血清学和分子生物学方法对该患者及其家系中9位成员进行血型鉴定和ABO血型基因测序,分析该家族血型的遗传特点;并对该血型的患者进行临床输血探讨,确保临床输血安全。结果患者为B(A)血型,与B101基因序列比对,均为nt640A>G,基因型鉴定为B(A)04/O01,B(A)型血清与同型红细胞以及O型、B型红细胞不凝集,B(A)型红细胞与同型以及AB型血清不凝集。结论血型血清学方法可以对正反定型不符的B(A)血型做出初步判断,分子生物学技术可以进一步准确判断该血型;临床输血应采取自体输血、同型输注及配合相容性输血。Objective To identify the blood type B（A）which is rare to see,and to investigate the concerned clinical blood transfusion safety strategies.Methods Automatic blood analyzer was used to detect ABO blood group,and the group typing and reverse typing of a patient were found to be inconsistent.Then the blood type and gene sequencing of this patient and nine of the family members were identified by blood group serology and molecular biology to analyze the genetic characteristic of the blood group of this family and clinical transfusion research was conducted on them to ensure the safety of clinical blood transfusion.Results Which wascontrasted with B101 gene sequence were all nt640 A〉G and B（A）04/O01 by gene identification.There was no agglutination between serum B（A）and O,B,B（A）red blood cells.B（A）red blood cells do not agglutinate with type B（A）and AB serum.Conclusion The group typing and reverse typing were identified as B（A）with blood group serology that could be further confirmed by molecular biological techniques;clinical blood transfusion should adopt autologous blood transfusion,same-type infusion and compatible blood transfusion.

关 键 词：ABO血型系统 B(A)亚型 血清学 家系调查 ABO基因分型 DNA测序 安全输血 

分 类 号：R392.11[医药卫生—免疫学]