Huang Xiao-Yan, Duan Fu-Cai, Li Da-Yuan, Li Ting-Ting, Xiao Fang, Cao Yan-Fei, Huang Ying
Gansu Provincial People Hospital, Laanzhou 730000,Gansu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Oct;21(5):1280-4. doi: 10.7534/j.issn.1009-2137.2013.05.039.
This study was aimed to investigate the genetic characteristics, identification method and transfusion strategy of rare blood type B(A). The rare blood group B(A) was typed by serological technique, PCR-SSP genotyping and sequencing of exon 6, 7 of ABO blood group. The genetic characteristics and molecular mechanism of B(A) blood group were also analyzed. Blood group compatibility test was conducted between blood donors of B(A) and recipients by clinical transfusion. The results showed that both forward and reverse grouping did not match the 3 cases of serological result in their family survey, while all of the 3 cases were grouped as AB blood group by forward grouping, B blood group by reverse grouping with serological result and B(A)04/001 group were genotyped by ABO genotyping. The patient of B blood group was transfused by 1 bag of washed red blood cells of donor of B(A) under closely monitoring, the patient's condition changed, and a mild adverse transfusion reaction was appeared. Washed red blood cell of O blood group was transfused into B(A) patient without blood transfusion reaction. It is concluded that the forward ABO serological grouping and reverse ABO serological grouping are not compatible, that may be verified by family survey and molecular biological methods. If in some cases transfusion therapy was applied, and group B(A) can not be transfused to the patient with group B or AB. Thus, transfusion compatibility or autologous transfusion can be adopted to transfuse to the patient from group B(A).
本研究旨在探讨罕见血型B(A)的遗传特征、鉴定方法及输血策略。采用血清学技术、PCR-SSP基因分型及ABO血型第6、7外显子测序对罕见血型B(A)进行分型,并分析B(A)血型的遗传特征及分子机制。通过临床输血对B(A)血型献血者与受血者进行血型相容性检测。结果显示,在其家系调查中,3例血清学结果正反定型均不相符,其中3例正定型均为AB血型,反定型按血清学结果为B血型,ABO基因分型为B(A)04/001型。对1例B血型患者在密切监测下输注1袋B(A)血型献血者的洗涤红细胞,患者病情发生变化,出现轻度输血不良反应。给B(A)血型患者输注O型洗涤红细胞未发生输血反应。结论:ABO血型正、反定型结果不相符,可通过家系调查及分子生物学方法进行验证。在某些情况下若需进行输血治疗,B(A)血型不能输给B型或AB型患者,可采用输血相容性检测或自体输血方式对B(A)血型患者进行输血。