摘要
在母儿血型不合的新生儿溶血病中，ＡＢＯ型占８３％，Ｒｈ型占１７％。对４１例夫妇ＡＢＯ血型不合的孕妇，检查免疫抗体Ａ（Ｂ）ＩｇＧ，效价＜１：６４，无一例发生溶血病现象，１５例效价≥１：６４，新生儿发生程度不同的溶血病。观察６６例服用预防中药的孕妇免疫抗体，４５例下降１／２～１／４，发病率从７６．９％下降至２６．３％。检测羊水血型物质判定胎儿血型，可确定母亲是否需要预防。除非分泌型外，阳性符合率１００％。用分光光度计测定４５０ｎｍ羊水胆红素的光密度，计算“膨出部”的数值，可分为轻、中、重３区，结合胎龄预测病情。所测１９例，Ⅰ区１１例，Ⅱ区５例，Ⅲ区３例，预测与临床病情一致。检查孕妇Ｒｈ（Ｄ）因子１１２６１例，Ｒｈ（Ｄ）阴性为６．５‰。对于曾有过流产、人工流产及输血史的孕妇检查Ｒｈ因子更为重要。
Objectives:To establish laboratory mehtods for prenatal hemolytic disease of newborn. Design:Clinical and laboratory studies. Setting:Hemolytic diseases laboratory,Peking Union Medical College Hospital. Method:A couple with a history of ABO incompatibility was examined for the titre of the immune anti-body A(B)IgG,when the woman was pregnant.Based on the coagulation inhibition principle,an exemina-tion of amniotic fluid blood substances was performed to determine the fetal blood group.The absorbence of the bilirubin in amniotic fluid,when measured in a continuously recording spectrophotometer,is demonstrable as a hump with maximum absorbence at 450 nm wavelength(OD450).The numerical value of the OD450 was calculated in correlation with fetal age to assess the degree of the hemolysis. Using the papain test to ex-amine the D factor of Rh. Results:When the immune antibody A (B)≥1 :64,the fetus was most likely affected.45 pregnent women treated with traditional Chinese herb,1/2～1/4 showed a reduction of the immune antibody titre。Except the non-secretory type,exmination if the fetal blood type using amniotic blood substances showed 100% accuracy。If the measurements of the amniotic bilirubin fall in Zone III, the fetus is already seriously effected,19 cases were examined(11 in Zone I,5 in Zone II ,and 3 in Zone lII),with their antenatal predic-tion completely conforming to what they suffered. Examination of Rh,D negative pregnant women is 6.5‰。Conclusion:Using laboratory mothods in prenatal diagnosis of the hemolytic diseases of new-born in combination with the clinical practice will make prevention and treatment of the diseases more accu-rate. Pregnant women,especially those who had history of spontaneous or induced abortion or blood transfu-sion,should have a routine examination of their blood group ABO and Rh. The methods introduced in this paper are simple and could be carried out in most hospitals so as to improve diagnosis and early prevention of the hemolytic diseases and early prevention of the hemolytic diseases of new-born.
出处
《生殖医学杂志》
CAS
1995年第4期213-216,共4页
Journal of Reproductive Medicine
关键词
血型不合
产前诊断
新生儿溶血病
Blood group incompatibility,Hemolysis Prenatal diagnosis
