误判O型的疑难血型鉴定及安全输血策略的研究  

Study on the Identification of Samples Mistyped as O Phenotype and the Strategy of Safe Blood Transfusion

作　　者：冯晨晨[1] 肖建宇[1] 史丽莉[1] 张若洋[1] 薛敏[1] 周彦君 黄成垠[1] 陈青[1,2] FENG Chen-Chen;XIAO Jian-Yu;SHI Li-Li;ZHANG Ruo-Yang;XUE Min;ZHOU Yan-Jun;HUANG Cheng-Yin;CHEN Qing(Jiangsu Province Blood Center,Nanjing 210042,Jiangsu Province,China;Center for Global Health,Nanjing Medical University,Nanjing 210042,Jiangsu Province,China)

机构地区：[1]江苏省血液中心,江苏南京210042 [2]南京医科大学全球健康中心,江苏南京210042

出　　处：《中国实验血液学杂志》2021年第3期910-916,共7页Journal of Experimental Hematology

基　　金：江苏省“十三五”期间“科教强卫工程”医学重点人才(ZDRCB2016010);江苏省重点研发计划社会发展项目(BE2015717);江苏省高层次卫生人才“六个一工程”拔尖人才项目(LGY2017095);江苏省第五期“333高层次人才培养工程”(2016-Ⅲ-3344)。

摘　　要：目的:综合探讨多种误判O型的疑难血型鉴定及安全输血策略。方法:收集2018-2019年本中心接收的无偿献血者和临床患者疑难血型复检标本,对表型为O型但疑似亚型标本使用试管法、吸收放散法等进一步验证;并采用分子生物学方法对受检者的相关血型基因进行检测。结果:14例表型被误判为O型的受检者中,共鉴定出11种基因型,其中无偿献血者3例,ABO血型基因型分别为Ael02/O02、Bel03/O02及1例类孟买B101/O02(FUT1:h3h3;FUT2:Se^(357)Se^(357));临床患者11例,ABO血型基因型分别为Ael02/O01、Ael02/O02(2例)、Ael08/O01、Aw37/O02、Aw43/O02、Bel03/O01、Bel03/O02(3例)及1例类孟买A102/B101(FUT1:h3h3;FUT2:Se^(357)Se^(357))。结论:Ael、Bel、Aw、类孟买等多种亚型的表型易被误判为O型。分子生物学手段有助于鉴定亚型基因型,合理安排相应的输血策略。Objective:To investigate the indentification method of samples mistyped as 0 phenotype and to explore the precision transfusion strategy.Methods:The blood samples from donors and patients admitted in our center from2018 to 2019 was collected.The samples with O phenotype suspected subtypes were further determined by tube test,adsorption-elution test,etc.Molecular testing was used to sequence the related blood type genes of the subjects.Results:Among 14 subjects misjudged as O,11 different genotypes were identified,in which 3 blood donors were Ael02/002,Bel03/002,and one para-Bombay with B101/002(FUT1: h3 h3;FUT2: Se^(357)Se^(357))] the genotypes of 11 patients were Ael02/001,2 cases with Ael02/002,AeL08/001,Aw37/002,Aw43/002,Bel03/001,3 cases with Bel03/002,and one case was para-Bombay with A102/B101(FUT1: h3 h3;FUT2: Se^(357) Se^(357)).Conclusion:The phenotypes of Ael,Bel,Aw and para-Bombay subtypes are easily misjudged as type 0.Molecular technology is helpful to identify the genotype of subtypes,and the corresponding transfusion strategies could be reasonably performed.

关 键 词：亚型 基因分型 输血安全 精准输血 

分 类 号：R457.1[医药卫生—治疗学]