ABO血型反定型无凝集患儿血清免疫球蛋白水平的分析  

Analysis of serum immunoglobulin levels in children without agglutination in reverse ABO blood group typing

作　　者：张聪[1] 张林[1] 邱碧波[1] 余强[1] 黄彩芝[1] Zhang Cong;Zhang Lin;Qiu Bibo;Yu Qiang;Huang Caizhi(Center of Clinical Laboratory,Hunan Children's Hospital,Changsha 410007,Hunan Province,China)

机构地区：[1]湖南省儿童医院检验中心,长沙410007

出　　处：《国际输血及血液学杂志》2021年第6期530-535,共6页International Journal of Blood Transfusion and Hematology

基　　金：湖南省卫健委应用研究指导课题(20200017)。

摘　　要：目的探讨年龄>6个月ABO血型反定型无凝集患儿的血清免疫球蛋白(Ig)G、IgM和IgA水平变化。方法选择2018年1月至6月,于湖南省儿童医院检验中心进行ABO血型正、反定型的1573例患儿中,反定型检测结果为无凝集的57例患儿为研究对象,并且纳入研究组。根据患儿年龄,将其分为A1亚组(n=32,年龄为6个月至1岁)与A2亚组(n=25,年龄>1岁)。研究组、A1亚组、A2亚组患儿的中位年龄分别为10.5个月(7.9~14.5个月)、8.3个月(7.0~9.8个月)、15.0个月(13.5~32.5个月);男性患儿分别为42、23、19例,女性分别为15、9、6例。采用随机数表抽样法,选择同期于本院儿童保健科体检且年龄匹配的60例健康儿童纳入对照组,并且按照年龄将其分为:B1亚组(n=30,年龄为6个月至1岁)和B2亚组(n=30,年龄>1岁)。对照组、B1亚组、B2亚组受试者的中位年龄分别为12.5个月(8.4~21.0个月)、8.4个月(7.5~10.5个月)、21.0个月(16.8~23.0个月);男性受试者分别为43、21、22例,女性分别为17、9、8例。采用试管法和微柱凝胶卡片法,对研究组患儿进行ABO血型正、反定型。采用免疫比浊法对所有受试者进行IgG、IgM和IgA检测。不同亚组患儿ABO血型反定型无凝集检出率比较,采用χ^(2)检验;研究组与对照组、不同亚组间的IgG、IgM、IgA水平比较,采用Mann-Whitney U检验。本研究遵循的程序符合湖南省儿童医院伦理委员会制定的标准,经过该伦理委员会批准(批准文号:HCHLL-2020-101),并征得受试者监护人知情同意。结果①研究组患儿的血清IgG、IgM和IgA中位水平,分别为5.17 g/L(3.87~6.85 g/L)、0.66 g/L(0.47~0.93 g/L)、0.23 g/L(0.14~0.42 g/L),均分别低于对照组的5.85 g/L(4.58~8.19 g/L)、0.85 g/L(0.65~1.08 g/L)、0.35 g/L(0.20~0.55 g/L),并且差异均有统计学意义(Z=-2.230、-2.391、-2.463,P=0.026、0.017、0.014)。②A2亚组患儿的血清IgG与IgM中位水平,分别为5.65 g/L(4.51~7.04 g/L)、0.73 g/L(0.49~0.96 g/L),均分Objective To explore changes of serum immunoglobulin(Ig)G,IgM and IgA levels in children whose reverse ABO blood group typing without agglutination and age were over 6 months.Methods From January to June 2018,a total of 57 children whose reverse ABO blood group typing without agglutination in 1573 children who were identified forward and reverse ABO blood group typing in Center of Clinical Laboratory of Hunan Children′s Hospital,were selected as study subjects and included in study group.These 57 children were divided into A1 subgroup(n=32,age of 6 months to 1 year)and A2 subgroup(n=25,age over 1 year old)according to their ages.The median ages of children in study group,A1 subgroup and A2 subgroup were 10.5 months(7.9-14.5 months),8.3 months(7.0-9.8 months)and 15.0 months(13.5-32.5 months),respectively;The numbers of male children were 42,23 and 19 cases,and those of female were 15,9 and 6 cases,respectively.Meanwhile,a total of 60 age-matched healthy children who underwent physical examinations in Pediatric Care Department of our hospital,were included into control group by random number table sampling method.These 60 children were divided into B1 subgroup(n=30,age of 6 months to 1 year)and B2 subgroup(n=30,age over 1 year old).The median ages of children in control group,B1 subgroup and B2 subgroup were 12.5 months(8.4-21.0 months),8.4 months(7.5-10.5 months)and 21.0 months(16.8-23.0 months),respectively.Male children were 43,21,22 cases,and female were 17,9,8 cases in above 3 groups,respectively.The forward and reverse ABO blood group typing of children in study group were performed by test tube method and microcolumn gel card method.The levels of serum IgG,IgM and IgA of all children were determined by immunoturbidimetry method.Chi-square test was performed to compare detection rate of children without agglutination in reverse ABO blood group typing between different age.The levels of serum IgG,IgM and IgA between study group and control group,as well as different age subgroups were compared by Mann-whitne

关 键 词：ABO血型系统 血型不合 免疫球蛋白类 血型抗原 儿童 

分 类 号：R446.6[医药卫生—诊断学]