O型孕妇IgG抗体效价对新生儿溶血病早期诊治的临床价值  

Investigation on the clinical value of serum IgG anti-A(B) antibody titer of O-type puerperant in the early diagnosis and treatment of neonatal hemolytic disease

作　　者：高琦[1] 许桂平[1] 何海锋[1] 李晶晶[1] 康琼华[1] 侯益军 张罗川 刘志东[1] 邱红春 张娟[1] GAO Qi;XU Guiping;HE haifeng;KANG Qionghua;LI Jingjing;QIU hongchun;HOU Yijun;ZHANG Luochuan;ZHANG Juan(Transfusion Department,The Second Hospital Affiliated to Chongqing Medical University,Chongqing 400010,China.)

机构地区：[1]重庆医科大学附属第二医院输血科

出　　处：《中国输血杂志》2018年第6期628-630,共3页Chinese Journal of Blood Transfusion

基　　金：国家自然科学基金(81101318,81601826)

摘　　要：目的探讨O型孕妇血清Ig G抗-A（B）效价对新生儿溶血病（HDN）的预测及早期诊治的临床价值。方法选取2014年1月—2017年1月本院收治的896对O型孕妇及其新生儿,采用系统性回顾法分析所有孕妇与新生儿和新生儿生父的临床资料,包括血型、孕妇妊娠次数、产前不规则抗体筛查结果、产前血清Ig G抗-A（B）效价,新生儿HDN 3项试验等,分析孕妇产前血清Ig G抗-A（B）效价与HDN的发生情况之间的关系。结果 896名O型孕妇中,Ig G抗-A（B）效价≥64者占50.33%（451/896）;从首次妊娠到≥2次妊娠,孕妇Ig G抗-A（B）效价≥64者比例从34.52%（116/336）上升至77.78%（70/90）（P〈0.05）;随着孕妇Ig G抗-A（B）效价从64升至〉256,其新生儿HDN发病率从6.15%（12/195）升高至70.59%（24/34）,重度HDN比率从8.33%（1/12）上升至75%（18/24）（P〈0.05）。结论 O型孕妇随着其产前血清Ig G抗-A（B）效价升高,其HDN发病率及病情严重程度升高;监测O型孕妇产前抗体效价,有助于预测HDN发病率,具有重要的临床价值。Objective To investigate the clinical value of serum Ig G anti-A（ B） antibody titer in predicting neonatal hemolytic disease（ HDN） and early diagnosis and treatment. Methods A total of 896 O-type pregnant women and their newborns were selected as subjects,who were admitted to our hospital from January 2014 to January 2017. The clinical data of the pregnant women and newborns along with their natural fathers were systematically analyzed,including blood type,irregular antibody screening and prenatal serum Ig G anti-A（ B） antibody titer of pregnant women,three tests of HDN. All pregnant women＇s prenatal serum Ig G anti-A（ B） antibody titer and the occurrence of HDN in neonates were statistically analyzed. Results Among 896 cases,the pregnant women with a prenatal serum Ig G anti-A（ B） titer more than 64 accounted for 50. 33%（ 451/896）. With increased counts of pregnancy,the proportions of pregnant women with a prenatal serum Ig G anti-A（ B） titer more than or equal to 64 increased from 34. 52%（ 116/336） to 77. 78%（ 70/90）（ P〈0. 05）. As the titer of prenatal serum Ig G anti-A（ B） increased from 64 to more than 256,the incidence of HDN in neonates increased from6. 15%（ 12/195） to 70. 59%（ 24/34）,and the proportions of severe HDN increased from 8. 33%（ 1/12） to 75%（ 18/24）（ P〈0. 05）. Conclusion As the titer of prenatal serum Ig G anti-A（ B） of O-type puerperant increases,the incidence and severity of HDN increases. Therefore,the regular detection of prenatal serum Ig G anti-A（ B） of O-type puerperant plays an important role in the early diagnosis and treatment of HDN.

关 键 词：新生儿溶血病 O型孕妇 IGG抗体效价 妊娠次数 

分 类 号：R457.1[医药卫生—治疗学] R722.18[医药卫生—临床医学]