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目的:研究RhD抗原变异型同种免疫反应。方法:采用微柱凝胶卡方法检测2015-07-2016-06江夏区42 940例本地居民RhD抗原;应用不同厂家RhD抗原试剂对初筛RhD阴性进行RhD阴性确认;使用PCR-SSP法对初筛RhD阴性的样本行RhD基因分型应用抗人球蛋白试验检测初筛RhD阴性样本中的弱D;用吸收放散试验检测初筛RhD阴性样本中的Del;对初筛RhD阴性样本进行不规则抗体筛查和抗体特异性鉴定。结果:在42 940例中共检出179例RhD阴性;在179例初筛RhD阴性中使用血清学方法检出弱D 2例、Del 15例,应用PCR-SSP方法检出弱D 5例、D-CE(2-9)-D融合基因型12例、Del型40例;12例RhD-CE(2-9)-D中有2例产检出抗D抗体;5例弱D未检出抗D抗体;Ddel型人群中未检出抗体。结论:不同RhD的变异型对D抗原有不同的免疫反应;建立不同的输血策略保障输血安全。
Objective: To study RhD antigen variant alloimmunization. Methods: RhD antigen was detected in 42 940 local residents in Jiangxia district by micro-column gel card method. RhD negative was confirmed by RhD negative screening with different manufacturers of RhD antigen reagent. PCR- RhD-negative samples were screened for RhD genotyping Weak D in negative primary RhD-negative samples were detected using anti-human globulin assay; Del in negative RhD-negative samples was tested by absorbance-release assay; Antibody screening and antibody-specific identification. RESULTS: 179 cases of RhD negative were detected in 42 940 cases. Among 179 cases of primary RhD negative, 2 cases of weak D and 17 cases of Del were detected by serological method. 5 cases of weak D were detected by PCR-SSP, D There were 12 cases of -CE (2-9) -D fusion genotype and 40 cases of Del type. Anti-D antibody was detected in 2 of 12 cases of RhD-CE (2-9) -D and 5 cases of weak D were not detected Anti-D antibody; no antibody was detected in the Ddel-type population. CONCLUSION: Variants of different RhDs have different immune responses to D antigen. Different transfusion strategies have been established to ensure the safety of blood transfusion.