摘要
目的:探讨血型不合孕妇产前免疫性抗体检测对产后新生儿溶血病(HDN)诊断的价值。方法:采用常规血型血清学方法对386名ABO血型不合的孕妇进行产前IgG抗A或抗B效价测定及8名RhD阴性孕妇进行抗-D检测,并对IgG抗体进行亚型分型检测,分析产后HDN的发生与产前免疫性抗体检测的关系。结果:386例ABO血型不合的孕妇产前IgG抗A或抗B效价分布与血型分布无相关性(P>0.05)。IgG抗A或抗B效价≥64与产后发生ABO-HDN呈正相关性,随着抗体效价的升高呈上升趋势(P<0.05),抗体效价≥1 024时几乎不可避免地发生HDN;在对母亲及患儿血型IgG抗A或抗B抗体类型检测中发现IgG1和IgG2型;RhD阴性孕妇产生抗-D的频率为62.5%,产前抗-D效价持续升高可造成胎儿发育不良以至终止妊娠。结论:产前IgG抗A或抗B抗体效价水平越高越有可能发生HDN,效价高于1 024发生HDN的几率极高,产前抗-D效价持续升高将严重影响胎儿发育,与夫妇血型不合类型无关,且主要以IgG1和IgG2型抗体为主。
Objective： To explore the diagnostic value of detection immune antibody in pregnant women with blood group incompatibility for preventing hemolytic disease of the newborn（HDN）. Methods： 386 pregnant women with ABO blood group incompatibility and 8 RhD negative pregnant women were determinated IgG anti-A or anti-B or anti-D with conventional serology methods, to analysis IgG antibody subtype classification and the relationship between postpartum HDN occurs and prenatal immune alltibodies. Results：It＇s no correlation of ABO blood type with pregnant women pre- natal IgG anti-A,or anti-B titer distribution in 386 eases （P^0. 05）, IgG anti-A, or anti-B titer ~64 and postpartum occurred ~HDN have correlation, with the antibody titer rising, the occurred rate is rising（P〈0. 05）, antibody titer ≥1 024 are almost inevilable to occurred HDN; blood type IgG anti-A, or anti-B antibody type detection in the found IgG1 and IgG2 type; frequency of RhD-negative pregnant women anti-D to 62. 5%, if anti-D titer continued to rise, it can cause prenatal fetal development as well as the termination of pregnancy. Conclusion： The higher of leve IgG anti-A or anti-B antibodies titer in prenatal woman,the more likely HDN, the titer higher than 1 024 HDN occurs extremely high risk,anti-D titer continued to rise will seriously affect fetal development, it is no eorrelatinn with couples blood group incompatihilily type, IgG antibody subtype classification were dominated by IgG1 and IgG2 antibodies.
出处
《医学理论与实践》
2013年第19期2538-2540,共3页
The Journal of Medical Theory and Practice
关键词
孕妇
血型
效价
HDN
Pregnant women, Bblood group, Titer, HDN
