PCR-SSP对潜在输血需要住院患者ABO基因分型的检测效果与意义

【目的】 调查潜在输血需要住院患者的ABO血型基因,分析ABO表型相同输血中ABO基因型的错配输血几率。【方法】 对502例潜在输血需要的住院患者,采用血清学方法和聚合酶链反应-序列特异性扩增技术(PCR-SSP)检测ABO血型的表型及基因型。比较两种方法学对ABO血型表型的一致率;统计各ABO等位基因及各ABO基因型的频率;并分析潜在输血需要的住院患者在接受ABO血型表型相同的输血时,ABO基因错配输血几率。 【结果】 血清学与PCR-SSP对502例潜在输血需要的住院患者的ABO表型识别的一致率为100%。PCR-SSP技术检测出患者中常见ABO基因5个(O1、O2、A1、B1及A2)以及ABO基因型16个(O1O2、O1O1、B1O1、A1O1、A1O2、B1O2、O2O2、A1B1、A1A1、B1B1、A2O1、A2O2、A2B1和A1A2),而血清学仅能识别ABO表型。潜在输血需要住院的患者在接受ABO血型表型相同的随机输血中,与供者之间ABO基因型的错配率分别为:A型65.98%,B型57.39%,O型56.95%,AB型22.55%。 【结论】 PCR-SSP能识别ABO基因型,不仅可以作为血清学的有力补充,而且可能揭示输血治疗中不明原因的输血不良反应的临床原因,具有重要临床意义。

ABO Genotyping Using PCR-SSP and Its Clinical Significance in Patients with Potential Need of Blood Transfusion

【Objective】 To investigate the ABO genotyping result and analyze the genotype mismatch probabilities of the patients who have the potential need of blood transfusion. 【Methods】 Serology and polymerase chain reaction (PCR- SSP) were used to detect the ABO blood group phenotype and genotype of 502 hospitalized patients, respectively. The consistency of the two methods was checked, the frequencies of the ABO blood group genotypes in each phenotype were calculated, and the potential Genotype Mismatch Probability in case of undergoing blood transfusion without genotyping technique was analyzed. 【Results】 Serology and PCR-SSP had a 100% consistency in each ABO blood group phenotyping results. PCR-SSP found 5 common ABO alleles and 16 ABO genotypes. The heterozygote genotypes took up more than 50% in each phenotype. In case of undergoing blood transfusion without genotyping technique, the Genotype Mismatch Probabilities of each phenotype were: A: 65.98%, B: 57.39%, O: 56.95%, and AB: 22.55%. 【Conclusion】 PCR-SSP can identify 16 ABO blood group genotypes, and can identify ABO blood group genotype. In clinical blood matching test, potential risk exists if ABO blood group was detected only by serology, application of PCR-SSP ABO blood group genotyping in clinical practice would be useful in preventing unexplained blood transfusion reactions.