孕妇产前血型抗体效价与新生儿溶血病的检测结果分析  

Relationship analysis between blood group antibody titers in prenatal pregnant women and hemolytic disease of the newborn

作　　者：张趁利 庞桂芝 娄白敏 

机构地区：[1]新乡市中心血站,河南新乡453000

出　　处：《临床血液学杂志（输血与检验）》2018年第1期124-126,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:探讨新生儿溶血病(HDN)产前血型抗体效价检测与HDN发病的关系。方法:采用血型血清学方法,对453例ABO及Rh血型不合的孕妇做ABO、RhD血型鉴定、抗体筛选、抗体鉴定、抗体效价测定;对135例新生儿检测ABO、RhD血型鉴定、溶血3项试验。结果:产前孕妇IgG抗-A(B)效价<64的218例,占51.54%,≥64的205例,占48.46%;Rh血型不合中抗筛阴性18例,产生抗-D 12例,其中2例与ABO合并。建议效价IgG抗-A(B)≥64、IgG抗-D>2的服中药治疗,定期监测抗体效价。在135例新生儿中有8例未证实HDN,其余127例确诊为ABO溶血108例,RhD溶血10例,ABO合并RhD溶血2例,RhE、c溶血5例,抗M溶血2例。结论:HDN的临床表现程度与母体内的IgG效价有一定的关系,效价越高,HDN发生率越高。建议临床医生对血型不合的孕妇进行产前血清学检测,以便早期治疗,并对患儿进行溶血病检测,以免延误病情,造成不良后果。Objective：To investigate the relationship between blood group antibody titers in prenatal pregnant women and hemolytic disease of the newborn（HDN）.Method：ABO,RhD blood types,antibody screening,identification of the antibodies and antibody titers of 453 pregnant women were detected using blood group serologic methods.ABO,RhD blood types,diret antiglobulin test,free antibodies test and thermal elution test of 135 newborns were detected.Results：There were 218 cases with IgG-A（B）antibody titer lower than 64 in prenatal pregnant women with a rate of 51.54%and 205 cases with antibody titer higher than 64 with a rate of 48.46%.There were 18 cases with antibody screening negative with Rh blood types incompatibility,among which were 12 cases with anti-D,and 2 cases with ABO merge.It suggested that patients with IgG-A（B）antibody titer higher than 64 and IgG-D higher than 2 received medicine,and monitoring antibody titer regularly.There were 8 cases with nonconfirmed HDN in 135 newborns,108 cases diagnosed as ABO hemolytic,10 cases as RhD hemolytic,2 cases as ABO and RhD merge,5 cases as RhE,c and 2 cases was anti-M.Conclusion：The clinical manifestation of newborn hemolysis and IgG antibody titer in pregnant women might have a certain relationship.The higher antibody titer,the higher HDN incidence.It is recommended that clinicians perform prenatal serological tests on pregnant women with blood types incompatibility for early treatment and test of hemolytic in disease of the newborn,so as to avoid delaying the disease and causing adverse consequences.

关 键 词：新生儿溶血病 IgG抗-A(B) IGG抗-D 抗体效价 

分 类 号：R556.6[医药卫生—血液循环系统疾病]