孕妇血清IgG抗A抗B水平检测用于早期诊断ABO-HDN的临床价值分析  

Clinical Value of Detection of Serum IgG Anti-A and Anti-B Levels in Pregnant Women for Early Diagnosis of ABO-HDN

作　　者：陈蕾 罗明[1] 柳月霞 CHEN Lei;LUO Ming;LIU Yuexia(Nanyang Second People’s Hospital,Nanyang City,He’nan Province 473000)

机构地区：[1]河南省南阳市第二人民医院产一科,473000

出　　处：《医学理论与实践》2020年第24期4062-4064,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探讨孕妇血清IgG抗A(B)水平检测在早期诊断ABO新生儿溶血病(ABO-HDN)的临床价值。方法:选取2017年6月—2018年6月在我院就诊的血型为O型孕妇1120例,均检测血清IgG抗A(B)抗体效价,观察ABO-HDN发生情况。结果:1120例孕妇中,IgG抗A(B)抗体效价≤1∶32、1∶64、1∶128、1∶256、≥1∶512分别占20.00%、25.63%、20.54%、17.95%和15.89%;母婴血型O-A组血清IgG抗A(B)抗体效价≤1∶32比例为11.46%,明显低于O-B组和O-AB组(P<0.05);母婴血型O-A组血清IgG抗A(B)抗体效价1∶256比例为20.83%,高于O-B组(P<0.05);母婴血型O-A组血清IgG抗A(B)抗体效价1∶512比例为18.58%,高于O-B组和O-AB组(P<0.05);随血清IgG抗A(B)抗体效价升高,ABO-HDN发生率明显升高(P<0.05),IgG抗A(B)抗体效价达到≥1∶512时,ABO-HDN发生率达到44.94%;血清IgG抗A(B)抗体效价预测ABO-HDN发生的ROC曲线下面积为0.801,95%CI为0.773~0.830,P<0.05,当效价≥1∶128时,其预测灵敏度和特异度分别为92.70%和54.20%。结论:孕妇血清IgG抗A(B)水平检测在早期诊断ABO-HDN中有较好的应用价值,值得临床使用。Objective:To explore the clinical value of serum IgG anti-A(B)level in pregnant women in early diagnosis of ABO neonatal hemolytic disease(ABO-HDN).Methods:1120 pregnant women with type O blood group were selected from June 2017 to June 2018,the serum IgG antibody titers against A(B)were detected,the occurrence of ABO-HDN was observed.Results:Among 1120 pregnant women,the titers of IgG anti-A(B)antibodies≤1∶32,1∶64,1∶128,1∶256 and≥1∶512 accounted for 20.00%,25.63%,20.54%,17.95%and 15.89%respectively;the ratio of serum IgG antibody titer≤1∶32 in maternal and infant blood O-A group was 11.46%,which was significantly lower than that of O-B group and O-AB group(P<0.05);the ratio of serum IgG anti-A(B)antibody titer 1∶256 in maternal and infant blood O-A group was 20.83%,which was higher than that in O-B group(P<0.05);the ratio of serum IgG anti-A(B)antibody titer≥1∶512 in maternal and infant blood O-A group was 18.58%,which was higher than that in O-B group and O-AB group(P<0.05);the incidence of ABO-HDN increased significantly with the increase of serum IgG anti-A(B)antibody titer(P<0.05),the incidence of ABO-HDN reached 44.94%when the titer of IgG anti-A(B)antibody reached≥1∶512;the area under ROC curve of serum IgG antibody titer for predicting ABO-HDN occurrence was 0.801,95%CI was 0.773~0.830(P<0.05),the sensitivity and specificity were 92.70%and 54.20%when the titer was≥1∶128.Conclusion:Detection of serum IgG anti-A(B)level in pregnant women has a good application value in early diagnosis of ABO-HDN and is worthy of clinical use.

关 键 词：IGG抗A(B) ABO新生儿溶血病 孕妇 临床价值 

分 类 号：R446.11[医药卫生—诊断学]