孕晚期孕妇VE-Cad水平和IgG抗体效价联合检测对新生儿溶血病的产前诊断价值  

The value of combined detection of VE-CAD level and IgG antibody titer in prenatal diagnosis of neonatal hemolytic disease in third trimester of pregnancy

作　　者：邓茂云 伍金林 田芳 DENG Mao-yun;WU Jin-lin;TIAN Fang(Department of Neonatology,West China Second Hospital of Sichuan University,Chengdu Sichuan 610000,China;Department of Neonatology,Zizhong County People's Hospital,Neijiang Sichuan 641200,China)

机构地区：[1]四川大学华西第二医院新生儿科,四川成都610000 [2]资中县人民医院新生儿科,四川内江641200

出　　处：《临床和实验医学杂志》2023年第4期407-410,共4页Journal of Clinical and Experimental Medicine

基　　金：四川省科技厅应用基础项目(编号:2021YJ0211)。

摘　　要：目的研究孕晚期孕妇血浆血管内皮钙黏蛋白(VE-Cad)水平与血清IgG抗A/B抗体效价联合检测在新生儿溶血病(HDFN)产前诊断中的临床价值。方法选择研究对象为2020年1月至2022年1月入资中县人民医院的100例O型血Rh(D)阳性孕晚期孕妇,所有孕妇与其配偶的血型均不相同,测定孕妇血浆VE-Cad水平与IgG抗A/B抗体效价。根据HDFN发生情况划分为研究组(n=50)与对照组(n=50),研究组发生HDFN,对照组未发生HDFN。比较两组孕妇的血浆VE-Cad水平与血清IgG抗A/B抗体效价并分析其与患儿总胆红素的相关性,选取受试者工作特征(ROC)曲线分析HDFN产前诊断中VE-Cad水平与IgG抗A/B抗体效价的临床价值。结果研究组孕妇的血浆VE-Cad水平与血清IgG抗A/B抗体效价明显高于对照组,差异有统计学意义(P<0.05)。研究组孕妇血清IgG抗A/B抗体效价与新生儿总胆红素无明显相关性(P>0.05),而孕妇血浆VE-Cad水平与新生儿总胆红素呈正相关(r=0.426,P<0.05)。ROC曲线分析显示,孕妇血浆VE-Cad水平诊断HDFN的曲线下面积(AUC)、敏感度、特异度依次为0.763、80.96%、63.17%,血清IgG抗A/B抗体效价诊断HDFN的AUC、敏感度、特异度依次为0.863、88.11%、71.06%;VE-Cad水平与IgG抗A/B抗体效价联合检测诊断HDFN的AUC、敏感度、特异度依次为0.916、92.87%、84.22%。结论孕晚期孕妇血浆VE-Cad水平与血清IgG抗A/B抗体效价联合检测用于HDFN产前诊断中的临床价值优于单一VE-Cad水平或IgG抗A/B抗体效价,产前诊断效果显著。Objective To study the clinical value of combined detection of plasma vascular endothelial cadherin(VE-Cad)level and serum IgG anti-A/B antibody titer in prenatal diagnosis of neonatal hemolytic disease(HDFN).Methods One hundred pregnant women with type O Rh(D)positive blood in the third trimester admitted to Zizhong County People’s Hospital from January 2020 to January 2022 were studied.All pregnant women and their spouses had different blood types.The plasma VE-Cad level and IgG anti-A/B antibody titer of pregnant women were measured.According to the occurrence of HDFN,it was divided into study group(n=50)and control group(n=50).HDFN occurred in the study group,but not in the control group.The plasma VE-Cad level and serum IgG anti-A/B antibody titer of pregnant women in two groups were compared,and the correlation between them and total bilirubin of children was analyzed.The clinical value of VE-Cad level and IgG anti-A/B antibody titer in HDFN prenatal diagnosis was analyzed by selecting the receiver’s working curve(ROC).Results The plasma VE-Cad level and serum IgG anti-A/B antibody titer of pregnant women in the study group were significantly higher than those in the control group(P<0.05).In the study group,there was no significant correlation between serum IgG anti-A/B antibody titer and neonatal total bilirubin(P>0.05),but there was a positive correlation between maternal plasma VE-Cad level and neonatal total bilirubin(r=0.426,P<0.05).ROC curve analysis showed that the area under curve(AUC),sensitivity and specificity of plasma VE-Cad level in pregnant women for diagnosing HDFN were 0.763,80.96% and 63.17% respectively,and the AUC,sensitivity and specificity of serum IgG anti-A/B antibody titer for diagnosing HDFN were 0.863,88.11% and 71.06% respectively.The AUC,sensitivity and specificity of VE-Cad level combined with IgG anti-A/B antibody titer in the diagnosis of HDFN were 0.916,92.87% and 84.22% respectively.Conclusion The clinical value of combined detection of plasma VE-Cad level and serum IgG

关 键 词：新生儿溶血病 孕晚期孕妇 血管内皮钙黏蛋白 IgG抗A/B抗体效价 

分 类 号：R722.18[医药卫生—儿科]