O型血孕妇相关指标对新生儿ABO溶血病发生的影响  

Influence of indexes in pregnant women with O type on occurrence of ABO-hemolytic disease of newborn

作　　者：李彦美 李肖甫[2] 周世录 樊晶晶[2] 李付广[1] Li Yanmei;Li Xiaofu;Zhou Shilu;Fan Jingjing;Li Fuguang(College of Basic Medicine,Zhengzhou University,Zhengzhou 450000,Henan,China;Department of Blood Transfusion,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,China)

机构地区：[1]郑州大学基础医学院,河南郑州450000 [2]郑州大学第三附属医院输血科,河南郑州450052

出　　处：《实用检验医师杂志》2020年第3期135-138,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的探讨O型血孕妇相关实验室检查结果对新生儿ABO溶血病(ABO-HDN)发生的影响。方法选择2019年1—12月在郑州大学第三附属医院产科门诊或病房围产保健进行检查的702例O型血孕妇为研究对象,检测孕妇及配偶的ABO、Rh血型,采用微柱凝胶法测定孕妇血清免疫球蛋白G(IgG)抗-A(B)效价和不规则抗体。追踪分娩结局,对发生ABO-HDN的112例新生儿进行血型检测、新生儿溶血3项试验及不规则抗体筛查试验等。分析孕妇配偶和新生儿血型、妊娠次数、孕妇产前血清IgG抗-A(B)效价对ABO-HDN发生的影响。结果①配偶血型为AB型组的ABO-HDN发病率明显高于配偶血型为A型、B型组〔27.7%(28/101)比14.2%(44/309)、13.7%(40/292)〕,差异均有统计学意义(均P<0.05),配偶血型为A型、B型组的ABO-HDN发病率比较差异无统计学意义(P>0.05);②A型和B型血新生儿的ABO-HDN发病率比较差异无统计学意义(P>0.05);③随孕妇血清IgG抗体效价升高,ABO-HDN发病率呈上升趋势(P<0.05),以IgG抗体效价≥1:1024最高(56.0%);④不同妊娠次数各组ABO-HDN发病率比较差异无统计学意义(均P>0.05)。结论ABO-HDN发病率与母体孕期血清IgG抗体效价水平和配偶血型有关,尤其配偶血型为AB型的O型血孕妇,从孕早期开始监测IgG抗体效价,对预测ABO-HDN的发生具有临床价值。Objective To investigate the effect of laboratory results of pregnant women with blood type O on occurrence of ABO-hemolytic disease of newborn(ABO-HDN).Methods The 702 pregnant women with type O in the Third Affiliated Hospital of Zhengzhou University during January to December 2019 were selected as research objects.The ABO and Rh blood types of pregnant women and their spouses were detected.The serum immunoglobulin G(IgG)anti-A(B)titers and irregular antibodies were measured by micro gel method.The 112 newborns with ABO-HDN were followed up for ABO and Rh blood type test,hemolysis test and irregular antibody screening test.The effects of maternal spouse and neonatal blood type,pregnancy times,prenatal serum IgG anti-A(B)titer on incidence of ABO-HDN were analyzed.Results①The incidence of ABO-HDN in the group of husband with blood type AB was significantly higher than that in the group of husband with blood type A and B[27.7%(28/101)vs.14.2%(44/309),13.7%(40/292),both P<0.05],but there was no significant difference between the groups of husband with blood type A and B(P>0.05).②There was no significant difference in the incidence of ABO-HDN between type A and type B newborns(P>0.05).③The incidence of ABO-HDN increased with the increase of maternal serum IgG antibody titer(P<0.05),reaching the highest with IgG antibody titer≥1:1024(56.0%).④There was no significant difference between the number of pregnancies and incidence of ABO-HDN(all P>0.05).Conclusion The occurrence of ABO-HDN is related to the titer of IgG antibody during pregnancy and the blood type of spouses,especially for type O pregnant women whose husband's blood type is AB,it is necessary to monitor IgG antibody titer from early pregnancy,which is of clinical value in predicting the occurrence of ABO-HDN.

关 键 词：新生儿ABO溶血病 O型血孕妇 免疫球蛋白G抗体效价 

分 类 号：R722.18[医药卫生—儿科]