| ObjectiveThe objective of our study is to observe the serological Rh-negative individuals to study the relationship between genotypes and alloimmunization of D antibody. We focused on provide the theoretical guidance to rational utilization of Rh-negative blood and take distinctive rule of transfusion strategies for Rh-negative recipient. Methods1、Through inquest the case of Rh D negative from March in 2011 to June in 2013 the history of immunization to exclude the case that have not history of immunization. It was statistical classifications for the history of abortion and reproduction for pregnant woman, to research the influence between the production of anti-D and history of abortion and reproduction.2、Antibody was screening by micro-column gel method, and further antibody identification was performed for the positive of antibody screening samples. Rh phenotype was typed by Dia Clon Rh-Subgroups+k card.3、Analyzed DNA by sequence-specific primer polymerase chain reaction(PCR-SSP) technology. The Rh negative alleles have been used including Rh D positive、Rh D negative、RHD-CE(2-9)-D、DVa(Hus)、DVI III、weak D15 and DEL RHD1227 A. Results1、Among the 336 cases with history of immunization, 22 cases had history of blood transfusion and antibody screening test positive in cross matching test. The antibody was identified as anti-D. There were 46 anti-D positive in 314 cases with history of pregnancy, of which 4(4.2%) were anti-D in 98 G2P0 pregnant woman, 6(14.6%) were anti-D in 41 G2P1 pregnant woman, 10(8%) were anti-D in 125 G3P0 pregnant woman, 14(36.8%) were anti-D in 38 G3P1 pregnant woman, 12(85.7%) were anti-D in 14 more than three times pregnant woman.2、336 cases were Rh phenotyping by Dia Clon Rh-Subgroups+k card, 185 cases of ccee, accounting for 55.06%, 119 cases of Ccee accounting for 55.06%, 14 cases of CCee, accounting for 4.17%, 11 cases of cc Ee, accounting for 3.27%, 7 cases of Cc Ee, accounting for 2.08%.3、Among 68 cases with anti-D positive, 56 cases of ccee, accounting for 82.3%, 5 cases of Ccee,accounting for 7.4%, 4 cases of CCee, accounting for 5.9%, 2 cases of cc Ee, accounting for 2.9%, 1cases of Cc Ee, accounting for 1.5%. The phenotype of ccee was highest.4、336 cases were gene typing, 249 cases of d/d, accounting for 74.1%,168 cases of RHD1227 A, accounting for 20.2%,19 cases of RHD-CE(2-9)-D/d, accounting for 5.6%.5、Among 68 cases with RHD1227 A, 0 cases of ccee, 56 cases of Ccee,accounting for 82.4%,8 cases of CCee, accounting for 14.2%, 1 cases of cc Ee, accounting for 1.8%, 3 cases of Cc Ee, accounting for 5.36%.6、Among 68 cases with anti-D positive,63 cases of d/d, accounting for 92.6%,0 cases of RHD1227 A,5 cases of RHD-CE(2-9)-D/d, accounting for 7.4%.None of the RHD1227 A cases versus ture Rh D-negative and partial D formed allo anti-D. ConclusionThe serological Rh-negative individuals is rich in gene types and in different genetic backgrounds. Deletion of the RHD gene was the main molecular biologic characteristics of serological Rh-negative individuals in Beijing, with a secondary was RHD1227 A and RHD-CE(2-9)-D/d. The production of anti-D has relationship with times of abortion and reproduction.The d/d and partial D has risk of alloimmunization to the D antigen. The partial D recipernt should transfusion Rh-negitive blood, but when it served as donors its blood should as Rh-positive. RHD1227 A and C phenotype have closely relationship. The RHD1227 A blood has been considered Rh-positve blood. Accroding to D-variant individuals genotyping establishing a distinctive transfusion rule can rational utilization of Rh-negative blood. |
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