RhD阴性孕妇妊娠RhD阳性胎儿与新生儿溶血病的相关性分析  

Correlation analysis of hemolytic disease of newborn and RhD negative pregnant women carrying RhD positive fetus

作　　者：何子毅[1] 刘赴平[1] 胡应明[1] 张建强 

机构地区：[1]广东省东莞市中心血站,523930 [2]广东省东莞市道滘医院检验科,523930

出　　处：《重庆医学》2012年第8期748-750,共3页Chongqing medicine

基　　金：东莞市科技局科技计划资助项目(2009-145)

摘　　要：目的探讨RhD阴性孕妇产前免疫性抗D抗体的检出率与产后新生儿溶血病(HDN)发病率的相关性。方法收集2007年1月至2010年12月137例RhD阴性孕妇产前血样及40例产后血样,分析产前抗D抗体的检出率、产后HDN发病率及其与母儿ABO血型配合性的关系。结果 16例(12.60%)RhD阴性孕妇多次妊娠者检测到抗D抗体,10例首次妊娠者均未检出;产前血清抗D抗体的检出率低于产后(P<0.05);RhD阴性孕妇妊娠RhD阳性胎儿且母儿ABO血型不配合时HDN的发病率高于母儿ABO血型配合者(P<0.05),属ABO血型系统者HDN的发病率高于属Rh血型系统者(P<0.05);抗D抗体的检出率与母儿ABO血型配合性无相关性(P>0.05)。结论产前RhD阴性孕妇抗D抗体的检出率与产后发生HDN的相关性尚不明确;ABO血型不配合对RhD阴性孕妇发生RhD-HDN有保护作用,但对产生抗D抗体的检出率无影响。Objective To explore the correlation of prenatal detection rate of immune anti-D antibody of pregnant women with RhD negative blood type and the incidence rate of postpartum hemolytic disease of newborn（HDN）. Methods 137 prenatal blood samples of pregnant women with RhD negative blood type and 40 postpartum blood samples were collected from January 2007 to December 2010. Their prenatal detection rate of anti-D antibody,incidence rate of postpartum HDN and their relationship with maternal-fetal ABO-blood group compatibility were analyzed. Results Anti-D antibody was detected in 16（12.60%） pregnant women with RhD negative blood type and history of several pregnancies,and was not detected in 10 women in their first pregnancy. The prenatal detection rate of serum anti-D antibody was lower than that after delivery（P〈0.05）. The incidence rate of HDN for RhD negative pregnant women carrying RhD positive fetus with maternal-fetal ABO-blood group incompatibility was higher than those with maternal fetal ABO-blood group eompatibility（P〈0.05）, and the incidence rate of HDN for those belong to ABO-blood group system was higher than those belong to Rh-blood group system（P〈0.05）. No correlation was found between the detection rate of anti-D antibody and the maternal fetal ABO-blood group compatibility（P〉0.05）. Conclusion The correlation of prenatal detection rate of anti-D antibody of RhD negative pregnant women and the incidence rate of postpartum HDN is not clear. ABO-blood group incompatibility has a protective effect on RhD negative pregnant women from RhD-HDN,but no effect on detection rate of anti-D antibodies.

关 键 词：抗D抗体 RH血型系统 ABO血型系统 新生儿溶血病 

分 类 号：R446.6[医药卫生—诊断学]