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目的探讨稀有B(A)血型的遗传特性、鉴定方法及输血策略。方法对6例ABO定型正反不符的标本,采用试管法做血清学鉴定、流式细胞分析仪做表型鉴定、DNA序列测定方法等做分子生物学鉴定及相关家系分析,研究B(A)血型的遗传学特点,并讨论B(A)血型献血者与受血者临床安全和合理用血。结果血清学表现为ABO血型正反定型不一致,正定型为AB型,且H抗原明显增强,反定型血清中存在抗-A1,初定为AwB型。测序表明:第7外显子在B101序列的基础上,出现了B(A)02型nt700C/G的典型等位基因突变。结论通过血清学及分子生物学方面的分析,确定6例标本的基因型皆为B(A)02型与O01型杂合,B(A)血型患者应尽量配合性输注O型或B型洗涤红细胞及AB型血浆。
Objective To investigate the genetic characteristics of rare B (A) blood type, identification methods and blood transfusion strategies. Methods Six cases of ABO stereotyped positive and negative samples were identified by in vitro serological identification, phenotyping by flow cytometry and DNA sequencing. Molecular biology identification and related pedigree analysis were carried out to investigate whether B (A) Blood type genetic characteristics, and to discuss the B (A) Blood donors and recipients of clinical safe and rational use of blood. Results The serological results showed that the positive and negative typing of ABO blood group was inconsistent, the positive typing was AB type, and the H antigen was significantly enhanced. The anti-A1 was present in the antisense serum and the initial was AwB type. Sequencing showed that the 7th exon presented a typical allele of nt700C / G of type B (A) 02 on the basis of B101 sequence. Conclusion According to the serological and molecular biological analysis, the genotypes of 6 specimens are all identified as B (A) 02 and O01 heterozygous. Patients with B (A) blood type should try to cooperate with type O or B Wash red blood cells and AB type plasma.