摘要
目的探讨降低B(A)亚型漏检率及其临床紧急输血流程。方法对1例急诊手术患者,采用血清学方法进行血型鉴定,根据鉴定结果初步确认为ABO亚型,后采用2种方法进行交叉配血。运用PCR(聚合酶链式反应)对该患者的ABO血型基因扩增并测序,明确基因型。结果该患者血型血清学结果显示正反定型不符,正定型为A弱B强,血清中存在较弱的抗-A1,H抗原较B细胞明显增强;术中输注B型洗涤红细胞4U、AB型血浆600mL,无输血不良反应。患者ABO基因测序结果与A101标准序列比对,符合(A)02/O01基因型。结论B(A)血型的血清学特征不明显,血清学检测必须严格遵守标准化操作流程,降低漏检率。本研究对B(A)患者制定了紧急输血流程,保证临床用血。同时其明确鉴定需进一步结合分子生物学检测,ABO基因测序联合单克隆测序可以有效明确其分型,必要时可选择二代测序的方法。
Objective To investigate the method for reducing the misjudged rate of B(A)blood type and the optimum emergency transfusion procedure.Methods In one case of emergency surgery,ABO blood type was identified by standard serological method.Then two kinds of blood cross matching tests were used to determine the blood type for emergency transfusion.The exon 6 and exon 7 of ABO gene were amplified by PCR and the products were sequenced.Results The serological characteristics of the patient were discrepant.The cell grouping was AweakB while the serum grouping was B.There was stronger agglutination with anti-H lection than normal B cells.During the surgery,the patient totally received transfusion of 4 units of group B washed red blood cells and 600 mL plasma of group AB.No adverse reactions were observed.The genotype of the patient was B(A)02/O01.Conclusion The serological characteristics of B(A)blood group are not obvious,so that the standard operating procedure must be strictly followed.To ensure the safety of transfusion,this study developed an emergency transfusion procedure for patients with B(A)type.Molecular biological testing is essential for B(A)type detection.Gene sequencing combined with monoclonal sequencing can effectively identify most ABO subtypes,and next-generation sequencing can be selected when necessary.
作者
朱蓓蓓
蒋密
陆琼
周蓉
朱丽佳
杨春晨
戎瑞明
ZHU Beibei;JIANG Mi;LU Qiong;ZHOU Rong;ZHU Lijia;YANG Chun Chen;RONG Ruiming(Departmentof Transfusion,Zhongshan hospital,Hehai University,Shanghai 200032,China;Shanghai Blood Center;Shanghai Key Laboratory of OrganTransplantation,Zhongshan Hospital,Hehai University)
出处
《中国输血杂志》
CAS
2019年第9期877-879,共3页
Chinese Journal of Blood Transfusion
