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[RH因子与长期输血的β地中海贫血儿童的临床输血效果]

[RH Factor and Clinical Transfusion Effectiveness for β-Thalassemia Children with Long-Term Blood Transfusion].

作者信息

Wu Chang-Lin, Wang Xiao-Hua, He Jian-An, Gu Da-Yong, Dang Xing-Tang, Zhu Yi, Shao Chao-Peng

机构信息

Department of Blood Transfusion, The Second People's Hospital of Shenzhen, Shenzhen 518035, Guangdong Province, China.

Institute of Evidence Identification of Chongqing Yuzhong District Public Security Bureau, Chongqing 400038, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2015 Dec;23(6):1657-61. doi: 10.7534/j.issn.1009-2137.2015.06.024.

Abstract

OBJECTIVE

To investigate the irregular antibody production and its relationship with Rh factor genotypes and the loci of thalassemia gene mutations for the β-thalassemic children with long-term transfusion, so as provide experimental basis for clinical safe and effective transfusions for thalassemic children.

METHODS

The peripheral blood from 246 children with β-thalassemia was collected in our hospital; the extraction of genomic DNA and Rh factor (C/c, E/e) genotypes were assayed by PCR-SSP method, the irregular antibodies were screened and identified by serological method, the genotypes for thalassemia and gene mutations were analysed by PCR-RD method.

RESULTS

The genotypes of Rh factors classified by PCR- SSP in the 246 cases of β-thalassemia children were as follws: Ce/Ce (143/246, 58.1%), CE/ce (59/246, 24%), cE/cE (14/24, 5.7%), Ce/ce (12/246, 4.9%); The positive rate of irregular antibody was 7.7% (19/246), including anti-E (7/19), anti-c (5/19), anti-C (2/19), anti-E and anti-c (2/19), anti-e (1/19), anti-D (2/19); Of the 19 cases with positive irregular antibody, the genotypings of Rh factor were: Ce/Ce (11/19), CE/ce (2/19), cE/cE (2/19), Ce/ce (2/19), cE/ce (2/19); the gene mutations location of thalassemia for 19 cases with positive irregular antibody: CD41-42M (13/19), CD71-72M (2/19), IVS-II-654M (3/19), -28M (1/19).

CONCLUSION

The irregular antibody production for β-thalassemic children with long-term transfusion may have some relevance with Rh factor genotypes and thalassemia genetic mutations. This study possesses a certain significance for effective prevention of RBC alloimmune response of β-thalassemia children and improvement of efficacy and safety of clinical transfasion blood.

摘要

目的

探讨长期输血的β地中海贫血患儿不规则抗体产生情况及其与Rh因子基因型和地中海贫血基因突变位点的关系,为临床安全、有效地为地中海贫血患儿输血提供实验依据。

方法

收集我院246例β地中海贫血患儿的外周血;采用PCR-SSP法检测基因组DNA及Rh因子(C/c、E/e)基因型,采用血清学方法筛查和鉴定不规则抗体,采用PCR-RD法分析地中海贫血基因型及基因突变。

结果

246例β地中海贫血患儿经PCR-SSP法分型的Rh因子基因型如下:Ce/Ce(143/246,58.1%),CE/ce(59/246,24%),cE/cE(14/246,5.7%),Ce/ce(12/246,4.9%);不规则抗体阳性率为7.7%(19/246),其中抗-E(7/19)、抗-c(5/19)、抗-C(2/19)、抗-E和抗-c(2/19)、抗-e(1/19)、抗-D(2/19);19例不规则抗体阳性患儿的Rh因子基因型为:Ce/Ce(11/19),CE/ce(2/19),cE/cE(2/19),Ce/ce(2/19),cE/ce(2/19);19例不规则抗体阳性患儿的地中海贫血基因突变位点:CD41-42M(13/19),CD71-72M(2/19),IVS-II-654M(3/19),-28M(1/19)。

结论

长期输血的β地中海贫血患儿不规则抗体产生可能与Rh因子基因型及地中海贫血基因突变有一定相关性。本研究对有效预防β地中海贫血患儿红细胞同种免疫反应、提高临床输血疗效及安全性具有一定意义。

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