潍坊地区患者ABO血型鉴定困难原因分析  

Analysis of the Reasons for Difficulty in Identifying ABO Blood Group in Patients in Weifang Area

作　　者：王立萍[1] 李书杰 吴晓春 刘凯 李新菊[1] 冀宝军[1] 孙福廷[1] WANG Li-ping;LI Shu-jie;WU Xiao-chun(Blood Transfusion Department of Weifang People's Hospital,Shandong Weifang 261041)

机构地区：[1]潍坊市人民医院输血科,山东潍坊261041

出　　处：《医学检验与临床》2024年第6期11-15,54,共6页Medical Laboratory Science and Clinics

基　　金：山东省潍坊市卫生健康委员会项目,项目编号:WFWSJK-2022-219。

摘　　要：目的:探讨分析潍坊地区患者ABO血型鉴定困难原因,解决疑难输血问题。方法:应用全自动血型分析仪对2020年12月-2023年10月潍坊地区239388例患者血型标本进行ABO血型初检,正反定型不符的标本加做试管法+镜检、不规则抗体筛查等实验,仍无法确定血型的,应用PCR-SSP法检测ABO血型基因,SSP荧光PCR染料法鉴定血型亚型,必要时进行Sanger基因序列分析。结果:239388份标本检出正反不符标本248份,研究分析结果为:①ABO亚型所致95例(4.0/万),其中B基因发生突变频率(65/95)明显高于A基因(28/95);②抗原减弱所致94例(3.9/万),其中B抗原表达减弱(62/94)比A抗原减弱(29/94)更常见;③不规则抗体阳性所致34例(1.4/万),其中抗M抗体(25/34)检出率最高;④反定型抗体减弱/缺失所致25例(1.0/万),其中抗B抗体减弱或缺失(22/25)最常见。结论:血清学与分子生物学结合可以准确鉴定患者血型,有效解决患者血型鉴定困难导致的疑难输血问题。Objective:To explore the reasons for the difficulty in ABO blood type identification among patients in Weifang area,and to study a reasonable blood transfusion plan.Methods:The ABO blood group of 239388 patients in Weifang area from December 2020 to October 2023 was initilly examined by automatic blood group analyzer.The samples could not be determined by serological tests,ABO blood group gene was detected by PCR-SSP method,and blood group subtypes were identified by PCR-SSP fluorescent dye method.If necesary,Sanger gene sequencing was performed.Results:239388 samples were detected,and 248 samples were found to have mismatched positive and negative typing,The results were as follows:①95cases(4.0/10,000)werecausedby ABO subtype,andthe frequency of B gene mutation was significantly higher than that of A gene mutation;@94 cases(3.9/10,000)were caused by antigen attenuation,in which B antigen weakening(62/94)was more common than A antigen weakening(29/94),③34cases(1.4/10,000)were caused by irregular antibody positivity,Anti-M(25/34)was most common(25/34);25 cases(1.0/10,000)were caused by the attenuation/deletion of antibody in reverse grouping,and the attenuation/deletion of anti-B antibody(22/25)was the most common.Conclusion:The combination of serology and molecular biology can accurately identify the blood group of patients and effectively solve the dificult problem of blood transfusion caused by the dificulty of blood group identification.

关 键 词：潍坊地区 ABO血型 基因序列分析 

分 类 号：R446.6[医药卫生—诊断学]