O型母亲抗-A、抗-BIgG抗体效价与新生儿溶血病发病关系分析  

Analysis of relationship between pathogenesis of neonatal hemolysis and antibody titers of anti-A and anti-B IgG in mother with type O blood

作　　者：肖瑞卿[1] 林武存[1] 隆晓秋[1] 许聃[1] 曾杰[1] 杨民[1] 任德会[1] 张红[1] 

机构地区：[1]第三军医大学西南医院输血科,重庆400038

出　　处：《重庆医学》2006年第11期969-970,共2页Chongqing medicine

摘　　要：目的了解母亲体内免疫性抗-A、抗-B IgG抗体效价与ABO新生儿溶血性疾病发病关系.方法产前孕妇与丈夫标本按照常规鉴定ABO及Rh（D）血型,ABO血型不合者检测IgM与 IgG抗-A、抗-B抗体效价,检测孕妇血清溶血素效价;产后新生儿与母亲鉴定ABO及RhD抗原,ABO血型不合,患儿红细胞做直接抗人-IgG试验,患儿血浆游离抗体试验,患儿红细胞放散抗体3项试验.结果 80例孕妇抗体效价1∶2～8的共11例,占13.75%;1∶16～64的58例,占72.5% ;1∶128～512的共11例,占13.75% ; 新生儿溶血病阳性标本80例,3项试验均为阳性的52例,占总数65%;放散试验阳性的77例,占96.25%;直接抗人IgG试验阳性的65例,占81.25%.结论母亲O型婴儿A型的发病率明显高于B型,A型较B型重,A型3项试验阳性占71.6%,而B型只占51.85%.重庆地区ABO新生儿溶血病,母亲的免疫性抗-A、抗-B抗体效价引起新生儿溶血病临界值应在1∶16,检测溶血素没有参考价值.Objective To explore the relationship between the development of the hemolysis in neonate with ABO blood type and the antibody titers of IgA and anti-B IgG within the mother body. Methods The samples from the husband and the pregnant wife before delivery were collected for the identification of ABO and Rh（D） blood type. The IgM and IgG anti-A, anti-B antibody titers were determined in those with mismatched ABO blood type. The serum hemolysin titer was detected in the pregnant woman. The ABO and RhD antigens were identified in the mother and post partum neonate. If there was mismatch of ABO blood type, three items of test would be carried in the neonate, i.e. direct anti-human IgG of the neonatal erythrocytes, plasma free antibody test of the neonate and the spreading antibody test of the erythrocytes in the neonate. Results In the 80 pregnant women, there were 11 cases with antibody titer of 1 ： 2-8 （13.75%）, 58 cases of 1 ： 16--64 （72.5%） and 11 of 1 ： 128--512（13.75%）. There were 80 cases of samples with positive neonatal hemolysis, in which positive in all the 3 items was identified in 52 cases （65%） and positive spreading test in 77 cases （96.25%）, while positive direct anti-human IgG test in 65 cases（81.25%）. Conclusion There was higher tendency of hemolysis in neonate with type A than B blood when the mother was type O blood. And the severity of hemolysis was higher in those with type A than with type B. There was 71.6% of all three tests with positive results in the neonates with type A blood, while only 51.85% in those with type B. In the neonatal hemolysis in Chongqing area, the critical value of the immunological anti-A and anti-B antibody titers for neonatal hemolysis should be 1：16. Hemolysin test could be no help.

关 键 词：抗-A IGG抗体 抗-B IGG抗体 抗体效价 ABO新生儿溶血病 

分 类 号：R722.18[医药卫生—儿科]