摘要
目的 探讨O型血孕妇血清IgG抗A（B）血型抗体效价对新生儿溶血病（HDN）发病的影响.方法 选取2014年1月至2015年4月于陕西省汉中市中心医院进行产前检查及分娩,并且产前检查发现夫妇ABO血型不合的O型血孕妇725例,以及其分娩胎儿中发生HDN的98例新生儿为研究对象.采用微柱凝胶试验检测O型血孕妇血清IgG抗A（B）血型抗体效价,采用HDN 3项试验（直接抗人球蛋白试验、放散试验和游离抗体试验）检测新生儿HDN发生情况.统计学方法分析O型血孕妇血清IgG抗A（B）血型抗体效价及其新生儿发生HDN的相关性.本研究遵循的程序符合陕西汉中市中心医院人体试验委员会所制定的伦理标准,得到该委员会批准,征得孕妇及其家属知情同意.结果 ①O型血孕妇血清IgG抗A（B）血型抗体效价＜1∶ 64,=1;64,=1∶128,=1∶256与≥1∶512,其分娩新生儿中HDN发生率分别为3.0％,10.2％,21.5％,36.8％和88.2％.随着O型血孕妇血清IgG抗A（B）血型抗体效价增加,HDN发生率呈增加趋势（x2=176.033,P=0.000）.②HDN患儿黄疸及贫血严重程度,均与其O型血母亲血清IgG抗A（B）血型抗体效价无相关性（r=-0.138,0.025;P＞0.05）.③孕次≥2次O型血孕妇血清IgG抗A（B）血型抗体阳性率为53.1％,显著高于初次妊娠的O型血孕妇（40.7％）,并且差异有统计学意义（x2=10.745,P=0.001）;而不同年龄、孕龄O型血孕妇血清IgG抗A（B）血型抗体阳性率比较,差异均无统计学意义（x2 =0.850,0.111;P＞0.05）.结论 O型血孕妇血清IgG抗A（B）血型抗体效价,对于预测HDN的发生率有一定价值,但无法预测HDN病情严重程度.对疑似母婴ABO血型不合、孕次≥2次的O型血孕妇,应加强产前监测,进行早诊断、早治疗,改善妊娠结局.
Objective To investigate the effects of O-type blood maternal serum IgG anti-A（B） type antibody titer on hemolytic disease of newborn （HDN）.Methods A total of 725 cases of O-type blood pregnant women with couple ABO-type blood group incompatibility who received prenatal care and childbirth in Hanzhong Central Hospital,Shanxi Province from January 2014 to April 2015 and their 98 newborns with HDN were enrolled into this study,as research objects.O-type blood maternal serum IgG anti-A（B） type antibody titers were detected by micro-gel technique,the occurrence of HDN was detected by HDN three trials （direct Coombs test,elution test and free antibody test）.The correlation between O-type blood maternal serum IgG anti-A （B） type antibody titers and HDN occurrence was analyzed by statistical methods.In this study,the study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Hanzhong Central Hospital,Shanxi Province.Informed consent was obtained from all pregnant women and their families.Results ①When the O-type blood maternal serum IgG anti-A（B） type antibody titers were 〈1 ∶ 64,=1 ∶ 64,=1 ∶ 128,=1 ∶ 256 and ≥1 ∶ 512,the incidences of HDN in newborns were 3.0%,10.2%,21.5%,36.8% and 88.2%,respectively.With O-type blood maternal serum IgG anti-A（B） type antibody titers increasing,there was a corresponding increase trend in the incidence of HDN （x2 =176.033,P=0.000）.②The degree of jaundice and anemia of newborn with HDN had no correlation with O-type blood maternal serum IgG anti-A（B） type antibody titers （r=-0.138,0.025;P〉0.05）.③The O-type blood maternal serum IgG anti-A（B） type antibody positive rate of pregnant women with gravidity ≥2 times was 53.1 %,which was significantly higher than that of pregnant women with 1 time gravidity （40.7%）,and the difference was statistically significant （x2 =10.745,P=0.001）.While there had no significant differences among the O-type blood maternal serum IgG anti-A（B） type an
出处
《国际输血及血液学杂志》
CAS
2015年第6期472-476,共5页
International Journal of Blood Transfusion and Hematology
基金
江苏省重点研发计划社会发展项目（BE2015717）
江苏省“十二五”期间“科教兴卫工程”医学重点人才项目（RC2011088）
江苏省第四期“333工程”培养资金资助项目（BRA2015501）
关键词
幼红细胞增多症
胎儿
孕妇
O型血
IGG抗体效价
血型不合
Erythroblastosis,fetal
Pregnant women,O blood type
IgG antibody titer
Blood group incompatibility
