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目的研究柳州地区RhD初筛阴性献血者D变异体分布。方法 425例经盐水法初筛为RhD阴性献血者标本采用IAT试验确认弱D,对IAT阴性的血样进一步采用吸收放散试验检测Del型和真实D阴性。采用单克隆Ig M抗-C,c,E和e血清以盐水法检测Rh表型。参照文献方法计算RhD阴性献血者Rh基因频率、单体型频率和Rh表型期望值,并进行Hardy-Weinberg吻合度检验。结果 425例RhD初筛阴性献血者中共检出D变异体99例(23.29%),其中弱D18例(4.24%),Del型81例(19.05%);确认真实D阴性326例(76.71%)。18例弱D表型分布:Ccee 9例(50.00%)>CCee 4例(22.22%)>cc Ee 3例(16.67%)>CCEe 1例(5.56%)=ccee 1例(5.56%)。81例Del型表型分布:Ccee 47例(58.03%)>CCee 17例(20.99%)>ccee 11例(13.58%)>cc Ee 5例(6.17%)>cc EE 1例(1.23%)。326例真实D阴性表型分布:ccee 199例(61.04%)>Ccee 83例(25.46%)>CCee 22例(6.75%)>cc Ee 16例(4.91%)>cc EE 3例(0.92%)>Cc Ee 2例(0.61%)>CCEe 1例(0.31%)。本文Rh表型的观察值与期望值差异无统计学意义(P>0.05),Hardy-Weinberg吻合度检验良好。单体型频率特点:cde(0.696 7)>Cde(0.261 6)>cd E(0.0417)>Cd E(0.000 0)。基因频率特点:c(0.739 5)>C(0.260 5),e(0.960 7)>E(0.039 3)。结论柳州地区RhD初筛阴性献血者D变异体检出率较高,将弱D和Del型献血者认定为RhD阳性,可提高临床输血安全性。
Objective To investigate the distribution of D variant in negative blood donors with RhD screening in Liuzhou area. Methods A total of 425 cases of RhD-negative blood donors were screened by saline method for weak D with IAT test. The IAT-negative blood samples were further tested for Absorption and D-negative by absorption and desorption tests. Rh phenotype was measured by saline method using monoclonal Ig M anti-C, c, E and e sera. The Rh gene frequencies, haplotype frequencies and Rh phenotypes of RhD-negative donors were calculated according to the literature method, and Hardy-Weinberg test was performed. Results A total of 425 cases of negative D-negative blood donors were detected in 99 cases (23.29%) of D-negative blood donors, of which D18 cases were weak (4.24%) and 81 cases were Del (19.05%); 326 cases (76.71% . 18 cases of weak D phenotype distribution: 9 cases of Ccee (50.00%)> 4 cases of CCee (22.22%)> 3 cases of cc Ee (16.67%)> 1 case of CCEe (5.56%) = 1 case of ccee (5.56%). The distribution of Del type phenotype in 81 cases was: Ccee 47 cases (58.03%)> CCee 17 cases (20.99%)> ccee 11 cases (13.58%)> cc Ee 5 cases (6.17%)> cc EE 1 case (1.23%). There were 326 cases of true D negative phenotypes: ccee in 199 cases (61.04%), Ccee in 83 cases (25.46%), CCee in 22 cases (6.75%), ccEe in 16 cases (4.91%) and cc EE in 3 cases (0.92% > 2 cases of CeEe (0.61%)> 1 case of CCEe (0.31%). There was no significant difference between the observed and expected values of Rh phenotype in this article (P> 0.05), and the Hardy-Weinberg test was good. Haplotype frequency characteristics: cde (0.696 7)> Cde (0.261 6)> cd E (0.0417)> Cd E (0.000 0). Gene frequency characteristics: c (0.739 5)> C (0.260 5), e (0.960 7)> E (0.039 3). Conclusions The detection rate of D variant of negative blood donors in RhD screening in Liuzhou area is higher than that of RhD positive patients in Weak D and Del donors, which can improve the safety of clinical transfusion.