孕妇冷抗M抗体漏检致新生儿溶血病例分析  

Analysis of neonatal hemolytic disease caused by missed detection of cold IgG anti-M antibody in pregnant women

作　　者：郎嵘[1] 董雅静 汤毅楠 李小飞 Lang Rong;Dong Yajing;Tang Yi'nan;Li Xiaofei(Department of Transfusion,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院输血科,100050

出　　处：《北京医学》2023年第6期548-551,共4页Beijing Medical Journal

基　　金：首都卫生发展科研专项(2021-1G-2021)。

摘　　要：目的 探讨孕妇抗M抗体漏检致新生儿溶血病(hemolytic disease of the newborn,HDN)的原因及策略。方法选取2021年1—12月首都医科大学附属北京友谊医院就诊的孕妇5例。采用全自动血型仪微柱凝集法检测孕妇血型并筛查不规则抗体、采用盐水试管法检测MN抗原,采用微柱凝集法检测新生儿溶血三项。分析产妇血型、抗体筛查、鉴定补做试验和新生儿溶血试验等结果。结果 5例孕妇产前不规则抗体筛查阴性,复查产妇4℃不规则抗体筛查为阳性,经抗体鉴定为抗M抗体;新生儿溶血三项试验4℃微柱凝集法试验阳性。结论 传统微柱凝集抗人球蛋白法可导致孕妇冷反应抗M抗体漏检。建议孕妇增加盐水法检测不规则抗体,避免冷反应抗M抗体漏检致HDN。Objective To explore the causes and strategies of hemolytic disease of the newborn(HDN) caused by missed detection of anti-M antibody in pregnant women.Methods A total of five pregnant women treated in Beijing Friendship Hospital affiliated to Capital Medical University from January to December 2021 were selected.Automatic blood group instrument micro-column agglutination method was used for blood type and irregular antibody screening,saline test tube method was used for MN antigen detection,and micro-column agglutination method was used for neonatal hemolysis.The results of maternal blood type,antibody screening,identification make-up test and neonatal hemolysis were analyzed.Results The five pregnant women were negative for prenatal irregular antibody screening,and were positive for irregular antibody screening at 4 ℃ after reexamnation,and were identified as anti-M antibodies.Three tests of neonatal hemolysis were positive by 4 ℃ microcolumn agglutination.Conclusions Traditional microcolumn agglutination anti-human globulin method can lead to the missed detection of cold reaction anti-M antibodies in pregnant women.It is recommended that pregnant women should increase the detection of irregular antibodies by saline method to avoid the HDN caused by the omission of cold reaction anti-M antibodies.

关 键 词：新生儿溶血病 抗M抗体 不规则抗体筛查 孕妇 

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