RhD阴性孕妇的产前同种免疫分析及围产期新生儿溶血病的监测和预防  

Analysis on Prenatal Isoimmunization of RhD Negative Pregnant Women and Monitoring and Prevention of Hemolytic Disease of Newborn in Perinatal Period

作　　者：陈阳 CHEN Yang(Shenyang Central Blood Station(Liaoning Blood Center),110044)

机构地区：[1]沈阳中心血站(辽宁省血液中心),110044

出　　处：《临床输血与检验》2022年第1期42-45,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的分析RhD阴性孕妇发生同种免疫的情况,探讨产生抗-D抗体的原因,对围产期孕妇RhD新生儿溶血病进行监测和预防。方法采用血清学方法检测ABO血型及RhD抗原鉴定,间接抗人球蛋白试验进行RhD抗原阴性确证和抗体筛选,抗体筛选阳性的进一步做抗体鉴定及抗体效价测定。采用聚合酶链反应-序列特异性引物(PCR-SSP)方法检测亚洲型DEL(RHD^(*)01EL.01)。结果596例孕妇样本中,70例血清学确认RhD阴性,6例产生抗-D抗体。分子生物学方法鉴定亚洲型DEL,6例产生抗-D抗体孕妇排除DEL型。初次妊娠的RhD阴性孕妇和亚洲型DEL孕妇未发生抗-D同种免疫,8.57%多次妊娠发生抗-D同种免疫。结论RhD阴性孕妇产生抗-D同种免疫受多种因素影响,围产期定期监测抗-D水平,对未产生抗-D孕妇建议给予RhIG治疗,已产生抗-D孕妇的新生儿出生给予正确治疗。Objective Study on the isoimmunization of RhD negative pregnant women and explore the influencing factors of producing anti-D antibody,and to monitor and prevent hemolytic disease of newborn in perinatal period.Methods ABO blood group and RhD antigen were detected by the standard serological methods,RhD antigen negative confirmation and antibody screening were tested by indirect antiglobulin test.Asia Del(RHD^(*)01EL.01)was detected by PCR-SSP.Results Among 596 pregnant women,70 were confirmed to be RhD negative,of whom 6 produced the anti-D antibody.No anti-D antibody were observed in all first-time pregnant and Del type women.In multi-pregnant women,8.57%produce anti-D allo-immune response.Condusion Anti-D isoimmunization is affected by many factors and the level of anti-D is regularly monitored during perinatal period of RhD negative pregnant women.Anti-D immunoglobulin treatment is recommended for those pregnant women who do not produce anti-D,and appropriate treatment shoud be adopted to treat or prevent the newborns of pregnant women with anti-D.

关 键 词：胎儿与新生儿溶血病 Rh免疫球蛋白 RhD同种免疫 抗-D抗体 

分 类 号：R722.18[医药卫生—儿科]