妊娠期抗-M抗体检出率及妊娠结局分析  

Analysis of detection rate of anti-M antibody during pregnancy and pregnancy outcome

作　　者：陈君 宋艳 叶珍 王淑平 CHEN Jun;SONG Yan;YE Zhen;WANG Shuping(Shanghai First Maternity and Infant Hospital,School of Medicine,Tongji University,Shang-hai,200092,China)

机构地区：[1]同济大学附属第一妇婴保健院,上海200092

出　　处：《临床血液学杂志》2022年第10期728-731,734,共5页Journal of Clinical Hematology

摘　　要：目的:探讨妊娠期不规则抗体检测中抗-M抗体的检出率及其对孕产妇妊娠结局的影响,以提高临床对抗-M抗体的认识,增加孕产妇妊娠成功率。方法:应用NEO全自动血型分析仪进行不规则抗体检测,对阳性结果进行进一步抗体鉴定,并留取脐带血或采集静脉血进行新生儿溶血病(HDN)相关检测。结果:在24 646例孕妇中,检出不规则抗体阳性77例,其中抗-M抗体16例,占不规则抗体的比率为20.78%(16/77)。16例孕妇中有1例孕中期胎死,1例未在我院分娩。新生儿中3例因无任何临床症状未行检测,其余检出抗-M抗体引起的HDN 3例,疑似2例,通过采用不同的治疗方法患儿均治愈出院。结论:检出抗-M抗体孕产妇妊娠结局迥异,从无症状到胎儿严重贫血甚至死胎。所以对于抗体筛查试验阳性的孕妇应及时对其抗体类型、特异性及效价进行鉴定,辅助临床诊断,做到早干预、早治疗。Objective: To investigate the detection rate of anti-M antibody in irregular antibody detection during pregnancy and its effect on pregnancy outcome, in order to improve the clinical understanding of anti-M antibody and increase the success rate of pregnancy. Methods: The irregular antibody was detected by NEO automatic blood group analyzer, the positive results were further identified, and the umbilical cord blood or venous blood was taken for the detection of neonatal hemolytic disease(HDN). Results: Among 24 646 pregnant women, 77 cases were positive for irregular antibody, including 16 cases of anti-M antibody, accounting for 20.78%(16/77). Among the 16 pregnant women, one died in the second trimester and one did not give birth in our hospital. Among the newborns, 3 cases were not tested because there were no clinical symptoms, and the remaining 3 cases of HDN caused by anti-M antibody and 2 suspected cases were cured and discharged through different treatment methods. Conclusion: The pregnancy outcomes of pregnant women with anti-M antibody were very different, from asymptomatic to severe fetal anemia and even stillbirth. Therefore, pregnant women with positive antibody screening test should identify their antibody type, specificity and titer in time to assist clinical diagnosis and achieve early intervention and treatment.

关 键 词：不规则抗体 MNS血型系统 新生儿溶血病 抗-M抗体 

分 类 号：R722.18[医药卫生—儿科]