孕妇抗人类白细胞抗原免疫特征研究  

Study on immunological characteristics of HLA in pregnant women

作　　者：石翠英[1] 郭玉萍[2] 何路军[1] 

机构地区：[1]河北省血液中心,石家庄050071 [2]河北医科大学第二医院

出　　处：《临床血液学杂志（输血与检验）》2010年第2期205-206,209,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：河北省2008年医学科学研究重点课题计划指令性课题(No:08045)

摘　　要：目的:研究正常妊娠孕妇血液中抗人类白细胞抗原(HLA)免疫特征。方法:用ELISA方法筛查受检孕妇血液中HLA-I类和II类抗体及鉴定新生儿血小板减少性紫癜患儿血液中血小板抗体的类型。结果:163例孕妇中有54例(33.13%)发生了HLA免疫,54例中有44例(81.48%)产生了HLA-I类抗体,26例(48.15%)产生了HLA-II类抗体,16例(29.63%)同时产生了HLA-I类和II类抗体。HLA-I类抗体的OD值均在HLA-II类抗体OD值的2～5倍之间。抽检的10例HLA-I类抗体阳性孕妇中1例婴儿发生了新生儿血小板减少性紫癜,由来自母体的HLA-I类抗体引起。83例孕第1胎的孕妇中有21例(25.30%)产生了HLA抗体,57名孕第2胎的孕妇中有25例(43.86%)产生了HLA抗体,经χ2检验,2者之间差异有统计学意义(P<0.05)。结论:HLA-I类抗原免疫原性高于HLA-II类抗原;孕妇HLA免疫率与妊娠次数相关,检测孕妇是否发生HLA免疫并关注其对胎儿及新生儿的影响十分重要。Objective：To study the immunological characteristics of HLA in normal pregnant woman serum.Method：Anti-HLA class I and anti-HLA class II of normal pregnant women were tested by ELISA,and the types of anti-platelet antibodies in the infant serum with neonatal thrombocytopenia were identified by ELISA.Result：Among the tested 163 pregnant women,54（33.13%） were anti-HLA positive,in which 44（81.48%） had anti-HLA class I,26（48.15%） anti-HLA class II and 16（29.63%） both anti-HLA class I and class II.The OD of the anti-HLA class I were 2～5 times higher than that of anti-HLA class II.Among the tested 10 pregnant women with anti-HLA class I,a infant of one case occurred neonatal thrombocytopenia induced by maternal anti-HLA.In the 83 women with the first pregnancy 21（25.30%） gained anti-HLA,and in the 57 with the second pregnancy 25（43.86%） gained anti-HLA（P0.05）.Conclusion：The immunogenicity of HLA class I antigens is stronger than that of HLA class II antigens.The frequency of anti-HLA antibodies may be associated with the times of pregnancy,so it would be clinically important to detect anti-HLA immunisation for the pregnant women and care its influence to the fetus or neonates.

关 键 词：正常妊娠 白细胞免疫 HLA抗体 胎次 

分 类 号：R557[医药卫生—血液循环系统疾病]