【摘要】 目的研究血清学RhD阴性个体的基因多态性与抗-D同种免疫的关系,探讨不同基因型个体的个性化输血策略。方法用盐水法及间接抗人球方法(IAT)确定RHD阴性个体,采用序列特异性引物(SSP-PCR)技术分析样本的RHD基因同时进行抗体筛选和抗体鉴定确定产生抗-D的样本。结果在有免疫史的336例入组者样品中,249例(74.1%)个体完全缺失RhD基因,l68例(20.2%)个体携带RHD1227A等位基因,19例(5.6%)携带RHD-CE(2-9)-D融合基因。抗体鉴定产生IgG抗-D的个体68例,63例(92.6%)完全缺失RhD基因,5例(7.4%)携带RHD-CE(2-9)-D融合基因,携带RHD1227A等位基因未检出产生抗-D的个体。结论血清学确定RhD阴性个体的RHD基因型具有丰富的多态性和不同的遗传学背景。真实RhD阴性和部分D个体有D抗原免疫时存在同种免疫风险,作为受血者应输用阴性血。基因型为RHD1227A患者不会产生抗-D,在输血时可输用阳性血。更多还原

【Abstract】 Objective To study the genotypeing of Rh-negative individuals and analyze the relationship between genetic background and alloimmunization of D antigen. The transfusion strategies for Rh-negative recipient were explored.Methods Routine serologic tests were used for Rh phenotype and antibody identification. PCR-SSP based methods were used for genotyping of these samples. Results Among the 336 samples, 249 cases were real Rh-negative(74.1%), 168cases were DEL RhD 1227A(20.2%), 19cases were RHD-CE(2-9)-D(5.6%). By antibody identification, 68 cases were found tp have anti-D. Among the 68 cases, 63 cases were real Rh-negative(92.6%), 5 cases were RHD-CE(2-9)-D(7.4%), none of RhD1227A. Conclusion RhD genetic polymorphism do exists in RhD-negative individuals. Real RhD-negative and partial D have potential risks of alloimmunization to the D antigen. Patients who are RhD-negative and partial D should be transfused with Rh-negative blood. The RHD1227A recipients can be transfused with RhD-positive blood.更多还原