孕产妇血型抗体效价测定在产前诊断中的意义  

Significance of blood group antibody titer detection in prenatal diagnosis

作　　者：许进明[1] 周小玉[1] 华岚[1] 孙云雨[1] 杨金柱[1] 

机构地区：[1]南京医科大学第一附属医院输血科,南京210029

出　　处：《临床血液学杂志（输血与检验）》2009年第5期515-517,525,共4页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:通过对孕产妇血清中血型抗体效价的测定,旨在了解异常IgG抗-A(B)或抗-D水平在孕妇中的分布情况,探讨孕妇血清中IgG类血型抗体效价与新生儿溶血病(HDN)之间的关系,为预防及治疗HDN提供重要的实验依据。方法:采用凝聚胺法分别对1316例O型血孕妇和64例Rh(D)阴性血孕妇血清中IgG抗-A(B)和抗-D水平做出测定。对新生儿运用微柱凝胶法做HDN溶血3项检测。结果:①在所检测的1316例O型血孕妇中,IgG抗-A测定有802例,效价≥64为129例,异常检出率占总抗-A的16.1%;IgG抗-B测定有744例,效价≥64为135例,异常检出率占总抗-B的18.1%。其中89例IgG抗A(B)≥64O型血孕妇所生新生儿中,有22例患HDN,阳性率占24.7%;②64例Rh(D)阴性血受检孕妇中,5例检测出IgG抗-D抗体,抗体检出率占7.8%,新生儿中有3例患Rh-HDN。结论:①HDN的发病率随着母体内的IgG类血型抗体水平增高而增大;②对于Rh(D)阴性的孕妇,IgG抗-D效价与孕次成正相关。Objective： To study the distribution of abnormal IgG antibody A（B） or antibody D in pregnant women and explore the relationship between hemolytic disease of newborn （HDN） and the titers of IgG antibodies in pregnant women, in order to provide an important experimental basis for HDN prevention and treatment. Methods：The titers of IgG antibody A （B） and antibody D were measured in 1316 pregnant women with blood type O and 64 with Rh（D） negative blood type using polybrene method. The three hemolytic tests were designed to diagnose HDN in the newborn whose mother had the risk of HDN before delivery using microcolumn gel technique. Results： （D Among 1316 maternal sera with blood type O, antibody A and antibody B were 802 cases and 744 cases respectively. Titer of IgG antibody A more than 1 ： 64 were found in 129 cases with the abnormal detection rate of 16.1% in the total anti-A, whereas titer of IgG antibody B were 135 cases with the abnormal detection rate of 18.1% in the total anti-B. Among 89 newborns whose mother with blood type O were found the titer of IgG anti body A（B） more than 1 ： 64, 22 suffered from HDN （24. 7%）; ②In 64 pregnant women with Rh（D） negative blood type, antibody D were found in 5 cases （7.8%）, and 3 newborns developed Rh-HDN. Conclusion：① The incidence of neonatal HDN increased along with the increasing of the mother＇s IgG antibody levels. ② For the Rh （D） negative pregnant women, IgG anti-D titer was positively related to gravidity.

关 键 词：血型IgG抗体 新生儿溶血病 母婴血型不合 

分 类 号：R457.11[医药卫生—治疗学]