ABO-HDN患儿血型IgG抗体效价及亚型的分布特征分析  

Analysis of the Distribution Characteristics of IgG Antibody Titers and Subtypes in ABO-HDN

作　　者：陈源 张晓丹 叶若婷 吴伟祥 刘成义[1] CHEN Yuan;ZHANG Xiaodan;YE Ruoting(Department of Clinical Laboratory,Guang Dong Women And Children Hospital,Guangzhou 511442)

机构地区：[1]广东省妇幼保健院,广东广州511442

出　　处：《临床输血与检验》2023年第6期753-757,共5页Journal of Clinical Transfusion and Laboratory Medicine

基　　金：广东省自然科学基金资助项目(No.2020A1515010434)资助。

摘　　要：目的研究ABO新生儿溶血病(ABO-HDN)患儿IgG抗体效价及亚型的检测情况与分布特征,为临床诊治ABO-HDN提供实验室诊断依据。方法选择222例新生儿为研究对象,收集新生儿临床基本资料、溶血相关检测指标(总胆红素TBiL、间接胆红素IBiL、血红蛋白Hb)和蓝光治疗时长等数据资料,采用微柱凝胶法进行溶血三项试验、IgG抗体效价及亚型检测。分析IgG抗体效价与亚型的分布特点及其与患儿溶血严重程度的关系。结果新生儿溶血三项试验共检测出阳性142例,阴性80例,阳性组TBiL和IBiL水平高于阴性组,A型新生儿发病率高于B型新生儿,差异均具有统计学意义(P<0.05)。在新生儿血型IgG抗体效价检测中,游离抗体效价最高为16,放散抗体效价最高为32,随着患儿游离或放散抗体效价的升高,TBiL、IBiL含量及蓝光治疗时长呈升高趋势,Hb呈下降趋势。新生儿体内检测出IgG1和IgG1/G3亚型,IgG1和(或)IgG3抗体主要分布在高效价组(≥8),与低效价组(<8)相比,各溶血指标比较均具有统计学差异(P<0.05)。结论高效价的IgG抗体及IgG1/G3亚型与溶血严重程度相关,检测新生儿血型IgG抗体效价及亚型有助于临床判断和防治ABO新生儿溶血病。Objective To study the detection and distribution characteristics of IgG antibody titers and subtypes in newborns with ABO hemolytic disease(ABO-HDN),and provide laboratory diagnostic evidence for clinical diagnosis and treatment of ABO-HDN.Methods 222 newborns were selected as research subjects.Clinical basic data of newborns,hemolysis related testing parameters(TBiL,IBiL,Hb),and data of blue-ray therapy were collected.Three hemolysis tests,IgG antibodies titer and subtype detection were performed using microcolumn gel method.The distribution characteristics of IgG antibody titer and subtype were analyzed,as well as their relationship with the severity of hemolysis in newborns.Results A total of 142 cases were positive and 80 cases were negative.The levels of TBiL and IBiL in the positive group were higher than those in the negative group,and the incidence rate of newborns with type A is higher than that of type B,the difference was statistically significant(P<0.05).In the detection of IgG antibody titers in newborns,the highest titer of free antibody was 16,and the highest titer of release antibody was 32.With the increase of the titer of free or release antibody in newborns,the level of TBiL,IBiL,and Blu-ray treatment duration tended to increase,while Hb levels tended to decrease.IgG1 and IgG1/G3 subtypes were detected in the newborns,and IgG1 and/or IgG3 antibodies were mainly distributed in the high titer group(≥8).Compared with the low titer group(<8),each hemolytic parameter showed statistically significant differences(P<0.05).Conclusion High titer IgG antibodies and IgG1/G3 subtypes are associated with the severity of hemolysis.It can provide important laboratory data support and helpful for clinical diagnosis,prevention and treatment of ABO-HDN.

关 键 词：ABO新生儿溶血病 溶血三项试验 IGG抗体效价 IgG抗体亚型 

分 类 号：R722.18[医药卫生—儿科]