Analysis of Rh phenotype and RHD genotype of anti-D alloimmune population in Rh-negative pregnant women
-
摘要: 目的 探讨Rh(D)初筛阴性孕妇的Rh表型分布及抗D同种免疫个体的Rh表型与RHD基因型特征,从而对Rh(D)阴性孕妇制定不同的检测和防治策略。方法 整理2010年5月至2022年5月检测的Rh(D)初筛阴性孕妇的Rh表型。收集Rh(D)确认阴性或D变异型且抗体筛查阳性的标本,鉴定为Rh血型系统同种抗体的标本应用PCR-SSP方法鉴定RHD基因型,同时采用血清学方法检测Rh表型。结果 2010年5月至2022年5月,去除重复检测孕妇,共计729例Rh(D)初筛阴性孕妇,其中ccee 435例(59.67%)、Ccee 202例(27.71%)、ccEe 48例(6.58%)、CcEe 21例(2.88%)、CCee 19例(2.61%)、CCEe 3例(0.41%)、ccEE 1例(0.14%)。共有30例产生Rh血型系统同种抗体的Rh(D)初筛阴性孕妇,抗D 29例,抗E 1例。Rh确认阴性产生抗D的个体共28例,Rh表型ccee 24例,ccEe 4例,基因型均为RHD全缺失型;产生抗E的个体1例,Rh表型为Ccee,基因型为 DEL RhD1227A 纯合子。D变异型产生抗D的个体1例,Rh表型为Ccee,基因型为DVI Ⅲ 型。结论 徐州地区Rh(D)初筛阴性孕妇Rh表型以ccee为主。Rh表型为RhC-、基因型为RHD全缺失型及DVI Ⅲ 型的个体易产生抗D同种免疫,产前意外抗体筛查应重点监测。Abstract: Objective To investigate the phenotypic distribution of Rh-negative pregnant women and the Rh phenotype and RHD genotype characteristics of anti-D alloimmune individuals in this area, so as to formulate different detection and prevention strategies for Rh(D) -negative pregnant women.Methods The Rh types of Rh-negative pregnant women in laboratory tests from May 2010 to May 2022 were sorted out. The Rh-negative or D variant antibodies screening positive were collected, and the specimens identified as Rh system alloantibodies were identified by PCR-SSP method to identify the RHD genotype. The Rh phenotype was detected by serological method.Results From May 2010 to May 2022, a total of 729 pregnant women were excluded from repeated testing, including 435 ccee(59.67%), 202 Ccee(27.71%), 48 ccEe(6.58%), 21 CcEe(2.88%), 19 ccee(2.61%), 3 CCEe(0.41%) and 1 ccEE(0.14%). A total of 30 cases of Rh system alloantibodies were detected, including 29 cases of anti-D and 1 case of anti-E. A total of 28 cases of Rh-negative individuals with anti-D alloimmunization, 24 cases of Rh type ccee, 4 cases of ccEe, all of which were RHD full deletion genotype; 1 case of anti-E, Rh type Ccee and genotype was DEL RhD1227A homozygote. One case of D variant with anti-D alloimmunization, Rh type Ccee, and genotype was DVI Ⅲ .Conclusion The Rh phenotype of Rh(D) -negative pregnant women in Xuzhou area was mainly ccee. Individuals with RhC- negative, genotype RHD total deletion type and DVI Ⅲ type might be prone to anti-D alloimmunity, and prenatal accidental antibody screening should be monitored.
-
Key words:
- Rh-negative /
- Rh phenotype /
- anti-D alloimmune /
- RHD genotype
-
[1] 邵超鹏, 徐华, 徐群, 等. 汉族DEL型孕妇可免去抗-D产前检查[J]. 中国输血杂志, 2010, 23(9): 671-674. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201009011.htm
[2] 徐路琼. IgM、IgG抗-E和IgG抗-c 1例[J]. 中国输血杂志, 2014, 27(5): 543-544. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201405040.htm
[3] 闫芳, 张磊, 张烨, 等. 北京地区RhD阴性献血人群Rh血型研究[J]. 中国输血杂志, 2017, 30(1): 56-57. https://www.cnki.com.cn/Article/CJFDTOTAL-BLOO201701023.htm
[4] 赵娜, 王松云, 赖建秀, 等. 赣州地区献血者Rh血型分布统计和分析[J]. 江西医药, 2021, 56(7): 1084-1086. doi: 10.3969/j.issn.1006-2238.2021.07.063
[5] 陈安心, 吴俊杰, 徐凤娟, 等. 浙江汉族RhDEL表型的分子机理研究[J]. 中国实验血液学杂志, 2006, 14(5): 1029-1032. doi: 10.3969/j.issn.1009-2137.2006.05.039
[6] 陈强, 陈娟, 李政, 等. 中国部分地区RhD(-)汉族人RHD基因结构分析[J]. 中国输血杂志, 2000, 13(2): 73-77. doi: 10.3969/j.issn.1004-549X.2000.02.002
[7] 杨世明, 潘晓莉, 崔颖. Rh(D)抗原及Rh血型免疫性抗体检测的分析[J]. 细胞与分子免疫学杂志, 2004, 20(2): 257-260. https://www.cnki.com.cn/Article/CJFDTOTAL-XBFM200402042.htm
[8] Daniels G. Variants of RhD current testing and clinical consequences[J]. Br J Haematol, 2013, 161(4): 461-470. doi: 10.1111/bjh.12275
[9] 朱加强. 40例行换血治疗的Rh血型系统新生儿溶血病分析[J]. 临床血液学杂志, 2020, 33(10): 704-706. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXZ202010010.htm