血液病和恶性肿瘤的部分患者,尤其是白血病和多发性骨髓瘤患者,常因病情及治疗导致ABO血型正反定型不符,表现为ABO血型的抗原或抗体减弱.本研究分析正反定型不一致的原因,进行正确的红细胞分型和基因分型,对12份肿瘤患者正反定型不一致血液样本进行的血型血清学试验和吸收放散试验.对存在疑问的标本进行PCR扩增第6、7外显子和5-7内含子,对外显子序列进行基因测序.结果表明,9例标本通过血型血清学、吸收放散定型,6例为A型,2例为O型,1例为B型；3例血型血清学和吸收放散无法鉴定其血型的标本,经测序分别定型为O46,B108和A102型,其中有2例因为PCR扩增效果差或者测序结果矛盾,未能给出ABO基因型.结论:对ABO血型正反定型不一致无法定型的肿瘤患者的血液样本,可以采用血型血清血方法、基因分型及吸收放散的方法正确鉴定ABO血型,以保证输血的安全性和有效性.%In part of the patients with blood disease or malignant tumors,especially those with leukemia and multiple myeloma,the disease state and unsuitable treatment often resulted in the inconsistence between positive and negative ABO blood group,displaying attenuation of the antigen or antibody of ABO blood group.This study was purposed to analyze the couse of inconsistence between positive and negative ABO blood group and to perform the correct typing of erythrocytes and genes.The serology,absorption and elution test were used to examine the 12 tumor patient of the inconsistence between positive and negative typing.The 6th,7th exon and 5-7th introns were amplified by PCR for questionable samples,and the gene sequencing of exon was performed.The results showed that 9 specimens were determined as 6 of A group,2 of O group,1 of B group,3 cases were identified as O46,B108,and A102 group,respectively,by the serology,absorption and elution typing.The genotype of 2 cases among them was not identified because of the erroneous PCR amplified result or the contradicted sequencing results,failing to determine the ABO genotype.It is concluded that the serological method for blood grouping,genotyping,absorption and elution method can be used for the blood samples unable to typing because of the inconsistence between positive and negative typing of ABO group,therefore,guaranteeing the safety and effectiveness.
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