孕妇血清IgG型抗A(B)抗体效价联合新生儿网织红细胞水平在新生儿溶血病诊断中的应用价值  

Application Value of Maternal Serum IgG anti-A(B)Antibody Titer Combined with Neonatal Reticulocyte Level in the Diagnosis of Hemolytic Disease of the Newborn

作　　者：黄进 吴海燕 汪光斌 HUANG Jin;WU Hai-yan;WANG Guang-bin(Department of Blood Transfusion,People's Hospital of Ningguo City,Ningguo,Anhui 242300,China;Department of Neonatology,People's Hospital of Ningguo City,Ningguo,Anhui 242300,China)

机构地区：[1]宁国市人民医院输血科,安徽宁国242300 [2]宁国市人民医院新生儿科,安徽宁国242300

出　　处：《解放军医药杂志》2022年第9期73-76,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：安徽省自然科学基金(2008085MH131)。

摘　　要：目的探讨孕妇血清IgG型抗A(B)抗体效价联合新生儿网织红细胞水平检测在新生儿溶血病(HDN)诊断中的应用价值。方法选取2021年1月—2022年1月行全程产检的O型血孕妇270例,分析不同产次、年龄、IgG型抗A(B)抗体效价等孕妇的HDN发生差异,同时分析HDN和非HDN新生儿网织红细胞水平差异。结果本研究确诊HDN 22例(8.15%)。HDN组网织红细胞水平高于非HDN组(P<0.01)。IgG型抗A(B)抗体效价阴性孕妇HDN发生率低于IgG型抗A(B)抗体效价阳性孕妇(P<0.05)。经产妇IgG型抗A(B)抗体阳性率高于初产妇(P<0.05)。年龄≥30岁孕妇IgG型抗A(B)抗体阳性率高于年龄<30岁孕妇(P<0.01)。IgG型抗A(B)抗体效价联合网织红细胞水平预测HDN的受试者工作特征曲线下面积大于二者单独预测(P<0.05),其预测HDN的敏感度和特异度分别为91.00%和96.00%。结论IgG型抗A(B)抗体效价联合新生儿网织红细胞水平检测有助于预测HDN的发生,同时IgG型抗A(B)抗体效价与孕妇年龄、产次有关。Objective To explore the application of maternal serum IgG anti-A(B)antibody titer combined with neonatal reticulocyte level detection in the diagnosis of hemolytic disease of the newborn(HDN).Methods A total of 270 pregnant women with type O blood who underwent the whole process of prenatal examination in our hospital from January 2021 to January 2022 were selected.The differences in HDN among pregnant women with different parity,age,IgG anti-A(B)antibody titers,and the differences in reticulocyte levels between HDN and non-HDN groups were analyzed.Results Twenty-two cases(8.15%)of HDN were diagnosed.The reticulocyte level of HDN group was significantly higher than that of non-HDN group(P<0.01).The incidence of HDN in pregnant women with negative IgG anti-A(B)antibody titer was significantly lower than that in pregnant women with positive IgG anti-A(B)antibody titer(P<0.05).The positive rate of IgG anti-A(B)antibody in the multipara was higher than that in the primipara(P<0.05).The positive rate of IgG anti-A(B)antibody in pregnant women aged≥30 years was higher than that in pregnant women aged<30 years(P<0.01).The area under the ROC curve of IgG anti-A(B)antibody titer combined with reticulocyte level to predict HDN was significantly higher than single detection(P<0.05),and its sensitivity and specificity for predicting HDN were 91.00%and 96.00%respectively.Conclusion IgG anti-A(B)antibody titer combined with neonatal reticulocyte level detection is helpful to predict the occurrence of HDN,and IgG anti-A(B)antibody titer is related to the age and parity of pregnant women.

关 键 词：幼红细胞增多症 胎儿 孕妇 IgG型抗A(B)抗体效价 网织红细胞 产次 

分 类 号：R722.18[医药卫生—儿科]