恩施土家族苗族地区患者ABO正反定型不符原因及分子生物学分析  

Causes and Molecular Biology of ABO Typing Discrepancy among Patients in the Tujia and Miao Populations of Enshi

作　　者：杨牧云 邓红英 张杰 戴万案 YANG Muyun;DENG Hongying;ZHANG Jie(Department of Blood Transfusion,Women and Children's Hospital,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445099)

机构地区：[1]恩施土家族苗族自治州中心医院输血科 [2]恩施土家族苗族自治州中心医院检验科

出　　处：《临床输血与检验》2023年第6期773-777,共5页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探究恩施土家族苗族地区患者ABO正反定型不符原因及分子生物学分析结果。方法以2018年10月~2022年10月我院鉴定的59例ABO正反定型不符样本为研究对象进行回顾性研究。分别对样本进行吸收放散试验、意外抗体检测以及分子生物学检测,分析ABO正反定型不符原因,并对比血清学及分子生物学检测结果。结果59例ABO正反定型不符样本中正定型异常8(13.56%)例,反定型异常47(79.66%)例,正、反定型异常4(6.78%)例。男性比例62.71%(37/59)高于女性比例37.29%(22/59)(P<0.05);≥61岁年龄段比例42.37%(25/59)高于41~50岁年龄段比例32.20%(19/59)和51~60岁年龄段比例25.42%(15/59)(P<0.05)。17例ABO亚型样本中12(70.6%)例为土家族。59例正反定型不符样本中29(49.16%)例为意外抗体,17(28.81%)例为ABO亚型,13(22.03%)例为血清抗体减弱。17例ABO亚型中,A亚型6例(A2型1例,A3型4例,Ael型1例),B亚型4例(B3型3例,Bel型1例),AB3型2例,B亚型(A型)3例,cisAB型2例。17例ABO亚型中,有8例血清学结果与基因分型结果一致,一致率47.1%(8/17)。A亚型中以A 307/O 02基因型为主,B亚型中以B 303/O 02基因型为主。结论ABO亚型是恩施土家族苗族地区ABO正反定型不符的重要原因。亚型中A亚型以A307/O02基因型为主,B亚型以B 303/O02基因型为主。Objective To explore the causes and analyze the molecular biology of ABO typing discrepancy in patients of Tujia and Miao nationalities in Enshi.Methods Totally 59 cases of ABO typing discrepancy samples taken in our hospital from October 2018 to October 2022 were retrospectively investigated.The absorption and release tests,accidental antibody detection,and molecular biology testing were performed on the samples to examine the reasons for ABO typing discrepancy,and the serological and molecular biological testing results were compared.Results Among the 59 samples,there were 8(13.56%)cases of positive stereotype abnormalities,47(79.66%)negative,and 4(6.78%)both positive and negative.The proportion of males(62.71%,37/59)was higher than that of females(37.29%,22/59)(P<0.05).The proportion of the≥61-year-old group(42.37%,25/59)was higher than that of the 41-50-year-old group(32.20%,19/59)and that of the 51-60-year-old group(25.42%,15/59)(P<0.05).Twelve(70.6%)of the 17 ABO subtype samples were of Turkish origin.Among the 59 cases of ABO typing discrepancy,29(49.16%)were unexpected antibodies,17(28.81%)ABO subtypes,and 13(22.03%)serum antibodies weakened.Among the 17 ABO subtypes,there were 6 cases of subtype A(1 case of A2 type,4 cases of A3 type,1 case of Ael type),4 cases of subtype B(3 cases of B3 type,1 case of Bel type),2 cases of AB3 type,3 cases of subtype B(A type),and 2 cases of cisAB type.Among the 17 ABO subtypes,8 serological results were consistent with genotyping results,with a concordance rate of 47.1%(8/17).The A307/O02 genotype was dominant in subtype A,and the B303/O02 genotype in subtype B.Conclusion After excluding the physiological,pathological and experimental factors,the ABO subtype is the main cause of ABO typing discrepancy in the Tujia and Miao populations of Enshi.Among the subtypes,the A307/O02 genotype is the main type in subtype A,and the B303/O02 genotype is the main type in subtype B.

关 键 词：ABO血型 正反定型不符 盐水试管法 吸收放散试验 基因分型 

分 类 号：R392.4[医药卫生—免疫学]