微柱凝胶免疫分析技术检测孕妇IgG抗体亚型在评估新生儿溶血症中的应用  

Application of human IgG antibody subtypes detected by microcolumn gel immunoassay for evaluating hemolysis disease of newborn

作　　者：唐萍[1] 蒋川 曾理 谢巧云 李凌波 TANG Ping;JIANG Chuan;ZENG Li;XIE Qiaoyun;LI Lingbo(Zhongjiang People's Hospital,Zhongjiang,Deyang,Sichuan Province,618100)

机构地区：[1]四川省中江县人民医院,618100

出　　处：《中国计划生育学杂志》2023年第1期64-68,共5页Chinese Journal of Family Planning

基　　金：德阳市科技计划重点研发项目(2021SZZ091)。

摘　　要：目的:观察微柱凝胶免疫分析技术检测人IgG抗体亚型在评估新生儿溶血症(HDN)发生的应用效果。方法:选取2022年1月-2022年3月本院行母体抗体效价检测的孕妇50例,O型孕妇42例、Rh阴性孕妇8例,采用自主研发的微柱凝胶免疫分析技术对其IgG抗体亚型进行检测,根据孕妇总IgG抗体效价分组,效价<256纳入低效价组(n=19),≥256纳入高效价组(n=31)。检测各组孕妇血清中致敏抗体IgG亚型种类和含量,分析其与HDN的相关性。结果:50例中总IgG抗体效价>64有40例占80.0%,以256居多占30.0%。50例中有27例发生HDN(54.0%),且总IgG抗体效价越高HDN发病率越高(P<0.05)。高效价组IgG1含量高于低效价组,IgG3含量低于低效价组(P<0.05);高效价组和低效价组的IgG2、IgG4含量比较无差异(P>0.05);HDN患儿产后3d平均血清胆红素水平为(142.68±11.65)μmol/L,母体IgG1含量为(6.25±0.63)g/L,IgG3含量为(0.34±0.12)g/L。IgG1与新生儿血清胆红素水平呈正相关(r=0.603,P<0.001),IgG3与新生儿血清胆红素水平呈负相关(r=-0.675,P<0.001)。结论:对有溶血风险的孕妇早期行IgG抗体检测有利于HDN的早期诊断,IgG1、IgG3是HDN的主要致敏抗体,其含量与HDN的发病有关。本研究制备的微柱凝胶免疫检测卡可同时检测IgG1与IgG3含量,具有较好的临床实用性。Objective:To observe the application efficacy of human IgG antibody subtypes detected by microcolumn gel immunoassay for evaluating Hemolysis disease of newborn(HDN).Methods:A total of 50 pregnant women undergoing maternal antibody titer detection were enrolled as the research objects between January and March 2022.The IgG antibody subtypes were detected by self-developed microcolumn gel immunoassay.According to total titer of IgG antibody,these women were divided into group A(19 women with low IgG antibody subtypes,titer<256),and group B(31 women with high IgG antibody subtypes,titer≥256).The types and levels of sensitizing antibody IgG subtypes in serum of the women in the two groups were detected,and the correlation between which and the HDN occurrence was analyzed.Results:Among these 50 women,there were 40 cases with total IgG antibody titer>64,which accounted for 80.0%,and most cases(30.0%)with titer 256.There were 27(54.0%)women with HDN in 50 cases.The higher the total IgG antibody titer was,the higher incidence of HDN was(P<0.05).The IgG1 level of the women in group B was significantly higher than that of the women in group A,and the IgG3 level of the women in group B was significantly lower than that of the women in group A(P<0.05).There were no significant differences in the levels of IgG2 and IgG4 of the women between group B and group A(P>0.05).The average serum bilirubin level of the newborns in the postpartum 3 days was 142.68±11.65μmol/L,the levels of IgG1 and IgG3 of the women were 6.25±0.63g/L and 0.34±0.12g/L.The IgG1 level of the women was positively correlated with their neonatal serum bilirubin level(r=0.603,P<0.001),but the IgG3level of the women was negatively correlated with their neonatal serum bilirubin level(r=-0.675,P<0.001).Conclusion:For pregnant women with hemolysis risk,early detection of IgG antibodies is conducive to early diagnosis and intervention of HDN.IgG1and IgG3antibodies are the main sensitizing antibodies of HDN,the levels of which are closely related to HDN occurr

关 键 词：新生儿溶血症 微柱凝胶免疫技术 IGG抗体效价 IgG抗体亚型 

分 类 号：R446.6[医药卫生—诊断学] R722.18[医药卫生—临床医学]