母婴ABO血型不合新生儿红细胞放散液抗-AB的检测及意义  

The significance of detecting the anti-AB in the neonatal RBC dispersion solution

作　　者：吴远军[1] 卢庆晖[1] 吴勇[1] 朱学海[1] 刘彦慧[1] 周皓云[1] 陈宝婵[1] 刘兴玲[1] 刘艳[1] 

机构地区：[1]中山大学附属东华医院,广东东莞523110

出　　处：《中国医师杂志》2007年第11期1471-1474,共4页Journal of Chinese Physician

基　　金：广东省东莞市科技计划资助项目（[2005]199-70）

摘　　要：目的探讨母婴ABO血型不合,母亲为O型、新生儿为A型或B型时,检测新生儿红细胞放散液中的抗-AB对诊断ABO-HDN的意义。方法采用间接抗球蛋白试验,使317例O型母亲分娩的A型及B型新生儿红细胞充分洗涤后的热放散液与A、B、O型红细胞反应,如果与O型红细胞不凝集,与同型红细胞凝集则含有抗-A（B）、与B型或A型红细胞交叉凝集则含有抗-AB。结果317例新生儿中,有240例红细胞放散液中检出了抗-A（B）和（或）抗-AB,其中只检出抗-A（B）者79例,检出抗-A（B）＋抗-AB者157例,只检出抗-AB者4例;240例红细胞放散试验阳性新生儿中,红细胞放散液检出抗-AB及未检出抗-AB者的Hb及TBIL值差异均无统计学意义。结论对母亲为O型的A型及B型新生儿进行ABO-HDN血型血清学诊断时,应检测新生儿红细胞放散液中的抗-A（B）及抗-AB,二者都是ABO-HDN的诊断依据,只检测抗-A（B）可致部分ABO-HDN患儿漏检;红细胞放散液中是否检出抗-AB与HDN的严重程度无关。Objective To explore the significance of detecting the anti-AB in the neonatal RBC dispersion solution in the diagnosis of ABO-HDN, when the newborng blood type is A or B while the motherg blood type is O. Method Heat dispersion solution, which Was fully washed from RBC of 317 cases of neonates with type A or B whose mothers with type O, were applied with the indirect antlglobulin technique. If the heat dispersion solution did not agglutinate with the type O while agglutinate with the homeotype RBC, it showed that the solution contained anti-A（B）. If the heat dispersion solution cross agglutinate with type B or A, it showed that they contained anti-AB. Result Within the 317 newborns, anti-A（B） and （or） anti-AB were detected in RBC dispersion solution in 240 cases. Among them, anti-A（B） were detected in 79 cases, anti-A（B） and anti-AB were 157 cases, and only four cases were detected anti-AB. In the 240 newborns, there is no significant difference in Hb and TBIL between anti-AB positive and anti-AB negative newborns. Conclusion When the newborn ＇s blood type is A or B and the motherg blood type is O, both anti-A（B） and anti-AB should be detected in RBC dispersion solution. If only detecting anti-A（B） , it may lead to some ABO-HDN are missed. Whether anti-AB was found in RBC dispersion solution or not, anti-AB was not correlated with the severity of ABO - HDN.

关 键 词：幼红细胞增多症 胎儿 血型不合 ABO血型系统 抗体/血液 

分 类 号：R722[医药卫生—儿科]