急性白血病患者ABO血型抗原减弱与配血输血关系研究

摘要

Objective To investigate the manifestations and correct identification method of ABO blood group antigens weakening in the patients with acute leukemia(AL) and its relation with blood transfusion.Methods Two hundreds patients with AL in the hematology department of our hospital from January 2013 to June 2016 were selected as the research subjects.The ABO blood group was identified by using the serological method.The patients with ABO blood group antigens weakening were screened out.Their genotypes were analyzed by adopting the polymerase chain reaction-sequence specific primer(PCR-SSP) method.Then homotype blood transfusion was performed according to the genotyping results,moreover which were compared with blood transfusion effect in the blood group antigens normal group at the same period.Results Among 200 cases of AL,the occurrence rate of ABO blood group antigens weakening was 24.00%(48/200),in which acute myeloid leukemia(AML) accounted for 34.40%(43/125) and acute lymphocytic leukemia(ALL) accounted for 6.67%(5/75).After genotyping,48 cases of ABO blood group antigens weakening,A antigen weakening was in 18 cases,which was identified as the A blood group;B antigen weakening was in 22 cases,which was identified as the B blood group;A/B antigens were decreased in 8 cases,which were identified as the AB blood type.The transfusion reactions situation of ABO blood group antigens weakening was similar to that of the normal blood group antigens group,The difference between these two groups had no statistical significance(P>0.05).Conclusion ABO blood group antigens weakening has higher incidence rate in the patients with AL,which is more common in AML patients,conducting the blood group genetic detection in the patients with weakened ABO blood group antigens is conducive to distinguish the ABO blood group,thus to realize the same type of blood transfusion in order to improve the patient's antigen function and recover the patient's health.%目的 探讨急性白血病(AL)患者ABO血型抗原减弱表现形式、正确鉴定方法及其与输血的关系.方法 选取2013年1月至2016年6月该院血液科收治的AL患者200例为研究对象,采用血型血清学方法鉴定ABO血型,筛查出ABO血型抗原减弱的患者,并采用聚合酶链反应-序列特异性引物法(PCR-SSP)分析ABO血型抗原减弱的患者基因分型,根据基因分型结果对患者行同型输血,并与同期血型抗原正常组输血效果进行比较.结果 200例AL患者中ABO血型抗原减弱发生率为24.00%(48/200),其中急性髓系白血病(AML)占34.40%(43/125),急性淋巴细胞白血病(ALL)占6.67%(5/75).经基因分型,48例ABO血型抗原减弱患者中,A抗原减弱18例,确定为A血型;B抗原减弱22例,确定为B血型;A/B抗原均减弱8例,确定为AB型血.ABO血型抗原减弱输血反应情况与血型抗原正常组相似,2组比较差异无统计学意义(P>0.05).结论 AL患者ABO血型抗原减弱发生率较高,多见于AML患者,对ABO血型抗原减弱患者行血型基因学检测将有助于区分ABO血型,从而实现同型输血,以改善患者抗原功能,恢复患者健康.