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血清学及质谱鉴定抗-Jra

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目的 报告1例无输血史但产生高频抗体抗-Jra的孕妇抗体特异性鉴定过程。方法 采用盐水介质法和间接抗人球蛋白法(微柱凝胶卡、PEG)进行抗体筛选及抗体鉴定;检测患者除ABO血型外其他血型来排除相应的高频抗体;采用各种酶处理过的细胞与患者血浆反应,进一步判定抗体类型;采用人源抗-Jra检测患者Jra抗原,MAL-DI-TOF质谱检测体系对患者进行JR血型基因分型;测定抗体效价。结果 患者血型为O型RhD(+)、CcDEe,患者血浆与抗筛细胞以及抗体鉴定细胞盐水介质反应均阴性,抗人球蛋白介质反应均阳性,自身对照为阴性;患者Jra抗原血清学检测和质谱血型基因分型阴性;患者血浆抗-Jra效价为 1∶2。质谱发现其 4 号外显子存在纯合无义突变(c。376C>T)。结论 该患者因妊娠免疫产生同种高频抗原抗体抗-Jra。
Identification of anti-Jra antibodies by serology and mass spectrometry
Objective To report the antibody specific identification process of a pregnant woman who had no history of blood transfusion but presented high-frequency anti-Jra antibodies.Methods Antibody screening and identification were performed by saline and indirect Coomb's technique(microcolumn gel card,PEG).ABO,Rh and other blood group anti-gens were identified by saline.Further antibody identification tests were performed by the reaction between cells treated with various enzymes and patient plasma.Jra antigen was identified by human anti-Jraantibody.JR blood type genotyping was per-formed by MALDI-TOF mass spectrometry detection system.Antibody titer in serum was tested.Results The patient′s blood type was O with RhD(+)and CcDEe.The plasma reacted negatively with antibody screening and identification cells by saline,but positively by indirect globulin test.The self-control was negative.The patient′s Jraantigen was negative in sero-logical tests and mass spectrometry blood type genotyping.Mass spectrometry revealed a homozygous nonsense mutation(c.376C>T)in exon4.The anti-Jra antibody titer was1∶2.Conclusion The patient developed high-frequency anti-Jraantibod-ies during pregnancy.

plasmaJra antigenanti-Jra antibody

凌止发、曾小莉、袁学文、沈伟

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川北医学院附属医院 输血科,四川 南充 637000

上海市血液中心

血浆 Jra抗原 抗-Jra

四川省南充市社科项目

NC24B56

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(7)
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