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目的 追踪研究 1例弱D表型孕妇 (G4P0 )的胎母免疫状态和其RHD基因型。方法分别采用聚合酶链式反应 (PCR)技术、DNA序列分析技术和流式细胞术。结果序列特异性引物PCR(SSP PCR)检测RHD第 3～ 7、9～ 1 0外显子显示第 3～ 6外显子为阴性 ;编码区全长序列分析显示第 1～ 2 ,7～ 1 0外显子序列与正常RHD基因 致 ,其余外显子缺失 ,证实个例为部分D表型DVIⅢ型 ,其RHD基因型鉴定为CDVIe/cde。流式细胞术分析显示母亲体内存在胎儿红细胞 ,即胎母出血反应阳性 ,但血清中未发现抗 D ,胎儿出生后无新生儿溶血病 (HDN)发生。结论本例虽未发生HDN ,但在输血实践及临床抗D同种免疫的预防和监护中 ,笔者认为仍应将DVI表型个体作为阳性供者和阴性受者
Objective To study the immune status and RHD genotype of a pregnant female with weak D phenotype (G4P0). Methods Polymerase chain reaction (PCR), DNA sequence analysis and flow cytometry were used respectively. Results Sequence-specific PCR (SSP PCR) showed that the exons 3 ~ 7 and 9 ~ 10 of RHD were negative for exon 3 to exon 6. The full-length coding region showed that 1 ~ 2 and 7 ~ 1 0 exon sequence and normal RHD gene, the rest of the exon was deleted, confirmed that the case is part of the D type DVI Ⅲ type, the RHD genotype identified as CDVIe / cde. Flow cytometry analysis showed that there was fetal erythrocytes in the mother, that is, the mother’s hemorrhage was positive, but no anti-D was found in the serum and no neonatal hemolytic disease (HDN) occurred after the birth of the fetus. Conclusion Although HDN has not occurred in this case, in the practice of transfusion and clinical prevention and monitoring of anti-D alloimmunity, I think that DVI phenotype individuals should still be regarded as positive donors and negative recipients