摘要目的:探讨Fy(a-b＋)稀有血型及抗-Fy a不规则抗体的血清学与分子生物学鉴定方法。 方法:选择2018年9月于青岛大学附属医院就诊的1例因交叉配血不合，而将其血液标本送至青岛市中心血站输血研究所进一步进行血型及不规则抗体鉴定的慢性肾功能衰竭患者为研究对象。该例患者为男性，汉族，72岁，既往有数次输血史。对受检血液标本采用试管法进行ABO和Duffy血型定型、直接抗人球蛋白试验、不规则抗体筛选和鉴定。不规则抗体筛选和鉴定分别采用国产(黄种人来源)和进口(白种人来源)不规则抗体筛选细胞和鉴定细胞，并且分别采用盐水介质和抗人球蛋白2种介质。采用Sanger双脱氧链终止法对该受检DNA标本的Duffy基因的全外显子进行测序。本研究遵循的程序符合2013年修订版《世界医学协会赫尔辛基宣言》要求。结果:对本例患者血清及DNA标本的检测结果如下。①血型为O型、RhD阳性、Fy(a-b＋)，直接抗人球蛋白试验结果呈阳性。②血清标本中存在同种抗体和自身抗体，并且存在同种抗-Fy a不规则抗体。③其Duffy基因的第125位核苷酸碱基为AA纯合子，为Fy(a-b＋)稀有血型。 结论:采用不同人种来源的不规则抗体筛选细胞和鉴定细胞血清学试验，联合DNA测序技术，能准确鉴定Fy(a-b＋)稀有血型个体的血型及其不规则抗体。

abstractsObjective:To explore the serologic and molecular biological identification methods of a rare Fy(a-b+ ) blood group and anti-Fy a irregular antibody. Methods:In September 2018, one patient with chronic renal failure who was admitted to the Affiliated Hospital of Qingdao University and whose blood sample was sent to the Institute of Transfusion Medicine, Qingdao Blood Center for further blood type and irregular antibody identification due to cross-matching incompatibility was selected as the subject. This patient was male, Han nationality, and 72 years old, with blood transfusion histories. ABO and Duffy blood group identification, direct antiglobulin test, screening and identification of irregular antibodies for patient′s blood sample were carried out by test tube method. Two kinds of domestic (originated from yellow race) and imported (originated from white race) irregular antibodies screening cells and identification cells, as well as salt solution and anti-human globulin reagent were used for irregular antibodies screening and identification, respectively. The complete exon of Duffy gene of patient′s DNA sample was sequenced by Sanger dideoxy chain termination method. This study was in line with World Medical Association Declaration of Helsinki revised in 2013. Results:The test results of this patient′s blood and DNA samples were as follows: ① The patient was O blood type, RhD positive, and Fy (a-b+ ) blood type. The result of direct antiglobulin test was positive. ② The results of irregular antibody screening suggested the presence of alloantibodies and autoantibody in patient′s serum sample. The results of irregular antibody identification confirmed the irregular antibody was anti-Fy a alloantibody in the patient′s serum sample. ③DNA sequencing of Duffy gene exon displayed there was AA homozygous at c. 125, which confirmed the patient was a rare Fy(a-b+ ) blood group. Conclusion:For accurately identify rare Fy(a-b+ ) blood group and irregular antibodies, it is necessary to using screening cells and identification cells from different ethnic origin for serologic test, combined with DNA sequencing technology.