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献血者ABO疑难血型血清学与分子生物学检测结果分析OACSTPCD

Analysis of ABO serological phenotype and molecular biology results of 256 blood donors with ambiguous blood group

中文摘要英文摘要

目的 正确鉴定ABO正反定型不相符献血者的血型并研究其表型与分子生物学特性.方法 微孔板法正反定型不相符的献血者标本分别进行盐水试管法血型血清学鉴定和聚合酶链反应-序列特异性(PCR-SSP)基因分型,并对部分献血者的PCR产物进行ABO基因 1-7 外显子直接测序,分析献血者的血型表型、基因分型及基因序列.结果 微孔板法ABO正反定型不相符的献血者标本 256 份,通过试管法血型血清学鉴定,正常ABO血型 119份,ABO血型抗体减弱 90 份,ABO亚型 47 份.256 份标本进行了PCR-SSP基因分型试验,除了 6 份标本基因分型无法明确判读外,233 份标本试管法血清学表型与基因型一致(91.02%),17 份表型与基因型不一致(6.64%).250份标本共计检出 17 种基因型:AO1(56 份)、AO2(58 份)、AA(50 份)、BO1(31 份)、BO2(17 份)、BB(8 份)、O1O1(2份)、O1O2(7 份)、AB(13 份),AO4、A205O2、A205A、A201A、O1O4、O2O2、A201B、A205B各1 份.对78 份标本ABO基因 1-7 外显子测序,共检出 29 个 ABO 等位基因,其中 7 个是常见等位基因:∗A101、∗A102、∗A104、∗B101、∗O01、∗O02、∗O04,23 个是少见或罕见等位基因:∗A201、∗A205、∗Ax01、∗Ax03、∗Ax13、∗Ax19、∗Ax22、∗Ael10、∗B305、∗Bel03、∗Bel06/∗Bx02、∗Bw07、∗Bw12、∗Bw17、∗Bw37、∗O05、∗O26、∗O61、∗B(A)04、∗B(A)07、∗cisAB01 和∗cisAB01var.另外发现 6 个罕见等位基因突变位点(c.101A>G;c.103_106delG;c.146_147insGC;c.259G>T;c.322C>T;c.932T>C).结论 疑难ABO血型的鉴定需要血清学检测和分子生物学检测相结合,提供明确的血型以保障临床用血安全.

Objective To correctly identify the blood group of ABO and study its molecular biological characteristics.Methods Blood samples from blood donors with discrepancies in forward and reverse typing using the microplate method were subjected to both saline tube agglutination test for serological identification and polymerase chain reaction-sequence specific primers(PCR-SSP)for genotyping.Additionally,direct sequencing of exons 1 to 7 of the ABO gene was performed on some donor samples to analyze their blood phenotype,genotype and gene sequence.Results For 256 samples showing discrepancy between forward and reverse typing in microwell method,119 were identified as normal ABO blood types,90 were weakened ABO antibodies and 47 were ABO subtypes by serology tube test.According to the PCR-SSP genotyping test,233 of 256(91.02%)were consistent with serological phenotype and genotype,17 of 256(6.64%)were inconsistent,and 6 samples can′t read genotype based on the kit result typing table.A total of 17 genotypes were identified in 250 samples as AO1 in 56,AO2 in 58,AA in 50,BO1 in 31,BO2 in 17,BB in 8,O1O1 in 2,O1O2 in 7,AB in 13,AO4 in 1,A205O2 in 1,A205A in 1,A201A in 1,O1O4 in 1,O2O2 in 1,A201B in 1 and A205B in 1.Sequencing of exons 1 to 7 of the ABO gene was carried out in 78 samples,and 29 ABO alleles were detected,seven of which were common alleles(∗A101,∗A102,∗A104,∗B101,∗O01,∗O02,∗O04),22 of which were rare alleles(∗A201,∗A205,∗Ax01,∗Ax03,∗Ax13,∗Ax19,∗Ax22,∗Ael10,∗B305,∗Bel03,∗Bel06/∗Bx02,∗Bw07,∗Bw12,∗Bw17,∗Bw37,∗O05,∗O26,∗O61,∗B(A)04,∗B(A)07,∗cisAB01 and ∗cisAB01var).In addition,six rare allele mutation sites were identified(c.101A>G;c.103_106delG;c.146_147insGC;c.259G>T;c.322C>T;c.932T>C).Conclusion The identification of ambiguous ABO blood group requires the combination of serological testing and molecular biological examination to correctly identify the blood type and ensure the safety of clinical blood transfusion.

陈兰兰;张燕华;车进;李凤;麻静敏;张嘉洪

北京市通州区中心血站,北京 101100

临床医学

ABO血型亚型表型基因分型基因测序

ABO blood groupsubtypephenotypegenotypesequencing

《中国输血杂志》 2024 (007)

766-772 / 7

北京市通州区卫生和计划生育委员会项目/北京市通州区"两高"人才工程专项基金(2017B0400247)

10.13303/j.cjbt.issn.1004-549x.2024.07.008

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