Rh血型不合的新生儿溶血病与不规则抗体相关性分析  

Correlation analysis of hemolytic disease of newborn with Rh blood group incompatibility and irregular antibodies

作　　者：范贞 乔静 庞新丰 柳沛 Fan Zhen;Qiao Jing;Pang Xinfeng;Liu Pei(Department of Blood Transfusion,Maternity and Child Health Hospital of Jiaozuo,Jiaozuo 454000,China;Department of Pediatrics,Maternity and Child Health Hospital of Jiaozuo,Jiaozuo 454000,China)

机构地区：[1]焦作市妇幼保健院输血科,454000 [2]焦作市妇幼保健院儿科,454000

出　　处：《国际遗传学杂志》2021年第1期20-23,共4页International Journal of Genetics

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ201901368)。

摘　　要：目的对非ABO血型系统发生的新生儿溶血病(hemolytic disease of newborn,HDN)进行回顾性分析,通过妊娠前产妇血清不规则抗体检测,得出不规则抗体在不同血型系统出现频率,分析分娩时血清不规则抗体效价及不规则抗体具体IgG/IgM类型,以及IgG型不规则抗体的免疫球蛋白分型,得出非ABO系统血型系统新生儿溶血病患儿与母婴血型不合产生的不规则抗体之间的关联。方法新生儿溶血病检测标本选择分娩时脐血,热放散结合微柱凝胶法进行溶血三项试验,确定是否发生新生儿溶血病。分娩前孕产妇进行不规则抗体试验检测,不规则抗体初筛试验检测阳性产妇,进行不规则抗体免疫球蛋白IgG/IgM类型,IgG效价水平测定。结果35例不规则抗体阳性中发生新生儿溶血病23例,阳性率65.7%。Rh血型系统发生HDN的21例产妇不规则抗体类型以IgG型抗体为主,占80.8%(21/26);Rh血型系统不规则抗体阳性发生HDN的产妇,血清免疫球蛋白分型以IgG1亚型为主。结论ABO血型之外常见的7种血型系统中,Rh血型系统发生HDN比例为80.8%(21/26),高于其他血型系统。分娩非ABO血型系统新生儿溶血病患儿的产妇,不规则抗体以IgG型抗体为主,免疫球蛋白分型中以IgG1亚型为主。Objective The frequency of irregular antibodies in different blood group systems was obtained through the detection of irregular antibodies in maternal serum before pregnancy.The titer of irregular antibodies,the specific IgG/IgM types of irregular antibodies and the immunoglobulin typing of irregular antibodies in parturients were analyzed to reveal the relationship between hemolytic disease of newborn(here in after referred to as HDN)with nonABO blood group system and irregular antibodies produced by maternalneonatal blood group incompatibility.Methods The test specimens of neonatal hemolytic disease were selected from the cord blood during delivery,and heat radiation combined with the microcolumn gel method was used for three hemolysis tests to determine whether neonatal hemolytic disease occurred.Before childbirth,pregnant women received irregular antibody test;among those who were positive in the first screening test for irregular antibodies immunoglobulin IgG/IgM type of the irregular antibody and IgG titer level were further determined.Results HDN occurred in 23/35(65.7%)cases with positive irregular antibodies.In Rh blood group system,21/26(80.8%)cases developed HDN whose irregular antibodies were mainly IgG;Among Rh blood group system with positive irregular antibodies and HDN,serum immunoglobulin type is mainly IgG1.Conclusion Among the seven common blood type systems other than ABO blood type,the proportion of HDN in Rh blood type system is 80.8%,which is higher than other blood type systems.For the parturients who give birth to children with neonatal hemolytic disease of nonABO blood group system,the irregular antibodies are mainly IgG antibodies,and the immunoglobulin classification is mainly IgG1 subtype.

关 键 词：RH血型 新生儿溶血病 免疫球蛋白亚型 

分 类 号：R722.18[医药卫生—儿科]