【摘要】 目的 研究RhD血型初检阴性孕妇RHD基因分型及RhD抗原同种免疫情况,为RhD-HDFN诊断及建立早期干预共识进一步积累相关资料。方法 采用常规血清学方法,进行RhD阴性确认及RhCcEe表型分型;采用盐水介质法及抗人球法筛查血清中意外抗体;分析抗体特异性并测定效价。同时提取DNA,采用PCR-SSP及测序方法进行RHD基因分型。结果 108例样本中,有6例RhD确认试验为阳性。最常见的Rh分型为ccee 61例及Ccee 37例。RHD基因分型共检出67例RHD~*01N.01、23例RHD~*01EL.01(即亚洲型DEL)、10例RHD~*01N.03、2例RHD~*06.03.01、3例RHD~*15、1例RHD~*05.03、1例RHD~*01W.33、1例RHD~*01N.25及1例新等位基因c.509 T>G(Genbank:MW923730)。共计11例样本检出意外抗体,1例为抗D、抗C(RHD~*01N.01),10例为抗D(8例RHD~*01N.01,1例RHD~*01N.03,1例RHD~*06.03.01);23例亚洲型DEL无一例产生抗D。结论 RHD基因存在诸多变异型,不同的亚型同种抗D免疫状态不一,未发现亚洲型DEL产生抗D,该型的抗D同种免疫风险较低。更多还原

【Abstract】 Objective To study RHD genotyping and RhD alloimmunization among perinatal women with RhD initial typing negative，and further accumulate relevant data for RhD-HDFN diagnosis and early intervention consensus.Methods Confirmatory test for Rh negative and RhCcEe phenotyping were performed by conventional serological methods.The screening of unexpected antibody was conducted by salt medium and antiglobulin methods.Further，specificity of antibodies and antibody titer were determined.DNA was extracted and RHD genotyping was detected by PCR-SSP and sequencing.Results Among 108 samples，6 cases were positive in RHD confirmatory test，and the most common Rh types were ccee (61 cases) and Ccee (37 cases).According to RHD genotyping，a total of 67 cases of RHD~*01N.01，23 cases of RHD~*01EL.01(Asia type DEL)，10 cases of RHD~*01N.03，2 cases of RHD~*06.03.01，3 cases of RHD~*15，1 case of RHD~*05.03，1 case of RHD~*01W.33，1 case of RHD~*01N.25 mutation and 1 case of new allele c.509 T>G(Genbank：MW923730)were detected.Unexpected antibodies were detected in 11 samples，including 1 case of anti-D and anti-C (RHD~*01N.01)，10 cases of anti-D (8 cases of RHD~*01N.01，1 case of RHD~*01N.03，and 1 case of RHD~*06.03.01).None of anti-D was detected in 23 cases of Asia type DEL.Conclusion There are many variants of RHD gene，and each subtype may have different immune states of anti-D.No Asia type DEL has been found to produce anti-D，which has a low risk of anti-D alloimmunity.更多还原