母胎Rh血型不合所致同种免疫反应  

Alloimmuneresponse caused by maternal-fetal Rh blood group incompatibility

作　　者：姚奎 姚强 YAO Kui;YAO Qiang(Department of Obstetrics and Gynecology,West China Second University Hospital of Sichuan University,Key Laboratory of Obstetrie&Gynecologic and Pediatric Diseases and Birth Defects of Ministry Education,Sichuan Chengdu 610041,China)

机构地区：[1]四川大学华西第二医院妇产科,妇儿疾病与出生缺陷教育部重点实验室,四川成都610041

出　　处：《中国妇幼健康研究》2020年第2期277-280,共4页Chinese Journal of Woman and Child Health Research

基　　金：四川省医学会资助项目(S16053).

摘　　要：母胎同种免疫反应指由于致敏作用在母体循环中产生抗胎儿红细胞抗原的相关抗体,继而进入胎盘循环与胎儿红细胞抗原结合,并导致溶血、贫血等疾病的同种被动免疫性疾病。母胎Rh血型不合是发生同种免疫反应的重要原因,多数Rh血型不合仅导致轻度或中度胎儿溶血,有20%左右的胎儿因严重溶血导致免疫性胎儿水肿。妊娠期可通过鉴定胎儿Rh血型、监测母血抗体浓度、监测胎儿超声相关指标如大脑中动脉收缩期血流峰值(MCA-PSV)等评估胎儿宫内情况。规范使用抗D免疫球蛋白可以有效减少同种免疫反应的发生,宫内输血则是治疗胎儿免疫性溶血的首选措施。Maternal-fetal alloimmune response is a passive immune diseases,which refers to maternal circulation due to sensitization to produce anti-fetal erythrocyte antigen related antibodies,then enter the placenta circulation and bind to fetal erythrocyte antigen,and lead to hemolysis,anemia and other diseases.Maternal-fetal Rh blood group incompatibility is an important cause of alloimmune response.Most incompatibility of Rh blood type only cause mild or moderate fetal hemolysis,and about 20%of fetuses cause immune hydrops fetalis due to severe hemolysis.During pregnancy,intrauterine conditions can be evaluated by identifying fetal Rh blood group,monitoring the concentration of maternal blood antibody and fetal ultrasonic-related indicators such as middle cerebral artery peak systolic velocity(MCA-PSV).Standardized using anti-D immunoglobulin can effectively reduce the occurrence of alloimmune response,and intrauterine transfusion is the first choice to treat fetal immune hemolysis.

关 键 词：RH血型 同种免疫 抗D免疫球蛋白 溶血 

分 类 号：R714.2[医药卫生—妇产科学]