妊娠患者ABO疑难血型基因分型及输血策略探讨  

Genotyping and Transfusion Strategy for Pregnant Patients with ABO Blood Typing Difficulties

作　　者：冯晨晨[1] 陈青[2] 韦晓[3] 史丽莉[1] 张若洋[1] 赵芳[1] 肖建宇[1] FENG Chen-Chen;CHEN Qing;WEI Xiao;SHI Li-Li;ZHANG Ruo-Yang;ZHAO Fang;XIAO Jian-Yu(Jiangsu Province Blood Center,Nanjing 210042,Jiangsu Province,China;Department of Blood Transfusion,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China;Key Laboratory of Yingbing Diagnosis and Treatment,Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing 210028,Jiangsu Province,China)

机构地区：[1]江苏省血液中心,江苏南京210042 [2]南京大学医学院附属鼓楼医院输血科,江苏南京210008 [3]南京中医药大学附属中西医结合医院瘿病证治重点研究室,江苏南京210028

出　　处：《中国实验血液学杂志》2025年第2期538-545,共8页Journal of Experimental Hematology

基　　金：江苏省卫生健康委员会指导性项目(Z2020046);江苏省输血协会英科新创科研项目(S2020006);江苏省输血协会爱康生物科研项目(JSAK2022007)。

摘　　要：目的:应用基因分型技术鉴定妊娠患者ABO疑难定型样本的血型,并结合临床探讨输血策略。方法:收集2021年1月至2022年12月本中心疑难血型基因检测开放平台接收的各地临床机构送检的36例ABO血型疑难的妊娠患者样本,利用血清学和基因检测方法鉴定血型表型及基因型。结果:36例样本共检出ABO亚型20例,包括10例BA/O,3例cisAB/O,2例A/Bw,1例A2/B,1例Aw/B,1例BA/B,1例BA/A,1例Bw/O;12例ABO基因测序后未发现与异常表型相关的特异性变异;检出4例类孟买血型。结论:ABO亚型干扰妊娠患者的ABO血型鉴定,同时妊娠状态也会影响血型表型。利用基因检测技术精准确定血型基因型能够指导妊娠患者临床输血,保障母婴安全。Objective:To identify the blood type of specimens from pregnant patients with difficult-to-type ABO status,and to guide clinical safe blood transfusion.Methods:The specimens from 36 pregnant patients with suspicious ABO blood group were collected.These specimens were submitted by clinical institutions from various regions to our center's genetic testing platform from January 2021 to December 2022.The blood group phenotypes and genotypes of these specimens were identified by serological method and genetic sequencing.Results:A total of 20 ABO subtypes were detected in the 36 samples,including 10 cases of BA/O,3 cases of cisAB/O,2 cases of A/Bw,1 case of A2/B,1 case of Aw/B,1 case of BA/B,1 case of BA/A,and 1 case of Bw/O.Additionally,4 cases were identified as para-Bombay blood type,and no specific variations associated with abnormal phenotypes were found in the remaining 12 cases.Conclusion:ABO subtypes interfere with ABO blood group identification in pregnant patients,and pregnancy status also affects blood group phenotype.Accurate determination of blood group genotype by genetic sequencing technology can guide clinical blood transfusion for pregnant patients,and ensure maternal and infant safety.

关 键 词：ABO亚型 基因分型 输血安全 产前筛查 

分 类 号：R446.1[医药卫生—诊断学] R457.1[医药卫生—临床医学]