等候肾移植患者中RHD阴性血液样品的基因分型及意义

发布时间：2018-03-29 17:42

本文选题：RhD血型阴性　切入点：肾移植　出处：《南方医科大学学报》2017年06期

【摘要】：目的探讨等候肾移植患者中RHD阴性血型基因血清学与分子生物学的差异。方法收集2006年1月~2016年1月广州市各器官移植中心等候肾移植的患者中经血清学检测为Rh D阴性的血样103例,采用分子生物学方法(定量PCR-测序技术)进行RHD基因分型。血清学与分子生物学两种方法对Rh D假阴性检出率行χ2检验。结果 103例血样中,Rh D真阴性(即10个外显子全部缺失)56例(54.5%),Rh D假阴性(即Rh D阳性,但是10个外显子中有部分缺失、重复、错义突变)47例(45.6%)。在47例Rh D假阴性中,弱D(weak D)1例(2.1%)、部分D(partial D)13例(27.7%)、放散D(D-elution)33例(70.2%)。血清学与分子生物学对Rh D阴性识别的差异呈统计学显著性(P0.05)。结论 103例血清学检测出的Rh D阴性中有45.6%通过分子生物学方法检测实际为Rh D阳性变异体,说明血清学技术对识别Rh D阴性呈较高错误率。利用分子生物学技术进行受者和供者RHD血型基因分型,对于精确肾移植配型具有重要的临床意义。
[Abstract]:Objective to explore the difference between RHD negative blood group gene serology and molecular biology in patients waiting for kidney transplantation. 103 Rh D negative blood samples, RHD genotyping was carried out by molecular biological method (quantitative PCR- sequencing technique). The detection rate of Rh D false negative was tested by two methods of serology and molecular biology. Results in 103 blood samples, Rh D was true negative (i.e. 10 cases). All exon deletions were found in 56 cases with Rh D false-negative (Rh D positive). But some of the 10 exons were missing, duplicated, and missense mutations were found in 47 cases, including 45.6%. In 47 cases of Rh D false-negative, One case of weak D(weak DU was involved with Rh D, 13 cases with partial D(partial D were involved with rh D, and 70.2% with D(D-elution)33. The difference between serology and molecular biology for Rh D negative identification was statistically significant (P0.050.Conclusion 45.6% of the 103 cases of Rh D negative detected by serological examination are by molecular biology formula. [WT5 "HZ] [WT5" HZ] [WT5 "HZ] [WT5BZ] [WT5BZ] [WT5BZ]. Method was used to detect Rh D positive variants. The results indicated that the serological technique had a high error rate in the recognition of Rh D negative, and the genotyping of recipient and donor RHD blood group by molecular biology was of great clinical significance for the accurate matching of renal transplantation.
【作者单位】：南方医科大学南方医院器官移植科;南方医科大学南方医院检验科;
【基金】：广东省科技计划项目(2014A020212582)
【分类号】：R699.2

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