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临床输血与检验

临床输血与检验 ›› 2016, Vol. 18 ›› Issue (6): 521-524.DOI: 10.3969/j.issn.1671-2587.2016.06.003

• 血型分子生物学 • 上一篇    下一篇

1例部分D表型孕妇抗-D及基因型分析*

党鑫堂,吴筱莹,王学东,伍昌林,朱奕,李妙珊,邵超鹏   

  1. 518035 广东省深圳大学第一附属医院、深圳市第二人民医院（党鑫堂,伍昌林,朱奕,李妙珊,邵超鹏）; 深圳市血液中心（吴筱莹）; 无锡市第五人民医院（王学东）
  • 收稿日期:2016-08-03 出版日期:2016-12-20 发布日期:2016-12-23
  • 通讯作者: 邵超鹏,（Tel） 0755-83216122（E-mail）cpshaos@hotmail.com。
  • 作者简介:党鑫堂（1974-）,男,河南焦作人,副主任技师,本科,主要从事血型相关研究,（Tel）13714054828。
  • 基金资助:
    *本课题受广东省医学研究基金（No.A2015054）、深圳市科技创新项目（No.JCYJ20140414170821221）资助

A Case of Pregnant Woman with Partial Anti-D and Its Genotyping

DANG Xin-tang, WU Xiao-ying, WANG Xue-dong, et al   

  1. The First Affiliated Hospital of Shenzhen University The Second People's Hospital of Shenzhen,Shenzhen 518035
  • Received:2016-08-03 Online:2016-12-20 Published:2016-12-23

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摘要： 目的分析1例孕妇抗-D同种免疫反应及部分D表型和基因型。方法分别采用盐水法和微柱凝胶卡法检测RhDCcEe抗原,以及常规血清学试管法和凝胶卡法鉴定孕妇血清抗-D抗体及其效价,通过检测RHD基因的10个外显子、RHD基因合子型,以及测定D抗原12个表位鉴定部分D表型。结果该个体盐水法测定为dCcee,但微柱凝胶卡法检测为DCcee表型,RHD基因外显子检测缺失第3~6外显子,合子型测定为D/d,D抗原表位分析显示缺失大部分D表位,提示该个体为部分D表型DVI-III型,基因型为DVICe/dce;孕妇血清抗-D抗体第20周第1次检测为阳性,效价为1∶32,至生产前为1：64,产后确认为Rh（D）新生儿溶血病,生下一子为Rh阳性。结论部分D表型DVI-III型过往国内亦有报道发生抗-D同种免疫反应和新生儿溶血病,我国汉族DVI-III型多见,产前检查时须防漏检。

关键词: Rh血型, D抗原, 部分D型, 抗-D

Abstract: ObjectiveTo analyze anti-D and genotype of the partial D phenotype in a pregnant women. MethodsThe RhDCcEe antigens were detected in saline by microcolumn gel card method. The serum anti-D and its titers were detected by routine serological method. The partial D phenotype was confirmed by detecting 10 RHD exons,zygosity and Depitops. ResultsThe pregnant women was found to have dCcee in saline,but DCcee in gel card. RHD gene was found to have deletion of exons 3-6 and the zygosity was D/d. Some of the red cell membrane D epitopes were negative. The results revealed a partial DVI-III phenotype with DVICe/dce genotype. The titer of anti-D was 1：32 in week 20 of pregnancy and 1：64 just before delivery. ConclusionSeveral pregnancies with partial DVI-III phenotype have been reported who presented positive anti-D reaction and hemolytic disease of the newborns. DVI-III is not rare in Chinese and misdiagnosis should be avoidedI in prenatal examination.

Key words: Rh, blood, group, D, antigen, Partial, D, Anti-D, Antibody

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