新生儿ABO血型抗体来源及效价的影响因素分析  

Analysis of the Influencing Factors of ABO Blood Group Antibody Origin and Titer in Neonates

作　　者：杨梦娇 张利 周宇 杨春 施香 YANG Meng-Jiao;ZHANG Li;ZHOU Yu;YANG Chun;SHI Xiang(Blood Transfusion Department,Shuangliu District First People’s Hospital/Sichuan University West China Airport Hospital,Chengdu 610200,Sichuan Province,China;Department of Blood Transfusion Medicine,The General Hospital of Western Theater Command,Chengdu 610083,Sichuan Province,China)

机构地区：[1]成都市双流区第一人民医院/四川大学华西空港医院输血科,四川成都610200 [2]西部战区总医院输血医学科,四川成都610083

出　　处：《中国实验血液学杂志》2025年第2期520-525,共6页Journal of Experimental Hematology

基　　金：四川省医院协会县级医院科研专项项目(2023LC011)。

摘　　要：目的:分析新生儿ABO血型抗体的来源及效价的影响因素。方法:选取2023年8月-2024年3月于成都市双流区第一人民医院收集的新生儿血液标本303例,检测新生儿ABO血型正定型、血浆中IgG和IgM血型抗体的总效价,用二硫苏糖醇(DTT)处理IgM类抗体后检测IgG类抗体效价,比较血型总抗体效价和IgG类抗体效价。收集母亲和新生儿的临床资料,分析抗体效价高低与各临床资料的相关性。结果:303例新生儿标本中,14例(4.62%)检出自身产生的血型抗体。母亲ABO血型对新生儿体内高效价血型抗体有影响:O>B>A>AB,不同血型组间差异有统计学意义(P<0.01)。123例(40.59%)O型血母亲所生的新生儿中,121例(98.37%)血型抗体效价>2;20例(6.60%)AB型血母亲所生的新生儿中,20例(100.00%)血型抗体效价<2。89例(29.37%)A型血母亲和71例(23.43%)B型血母亲中,当新生儿血型与母亲血型不相容时,新生儿血型抗体效价均<2;当新生儿血型与母亲血型相容时,新生儿血型抗体效价有高有低。新生儿血型抗体效价高低与母亲怀孕次数有关,与母亲流产次数、生产次数、胎儿胎龄等因素无关。结论:新生儿的ABO血型抗体主要来自母亲的IgG类抗体,新生儿自身产生的ABO抗体很少,部分新生儿的IgG类抗-A和(或)抗-B可在室温下与反定型细胞发生盐水凝集反应。母亲ABO血型是新生儿血型效价高低的主要影响因素。母亲怀孕次数与新生儿体内高效价ABO血型抗体有关。Objective:To analyze the origin and influencing factors the titer of ABO blood group antibody in neonates.Methods:A total of 303 newborn blood samples collected in our hospital from August 2023 to March 2024 were selected for the detection of ABO blood group settings and the determination of the total titers of IgG and IgM blood group antibodies in plasma.IgM antibodies were treated with dithithreitol(DTT)to determine the titers of IgG antibodies.The total titer of the blood group antibody was compared with that of the IgG antibody.The clinical data of mothers and newborns were collected,and the correlation between the antibody titer and these clinical data was analyzed.Results:Among the 303 newborn specimens,14 cases(4.62%)were identified to possess blood group antibodies.The influence of the maternal ABO blood group on the generation of high-potency blood group antibodies in newborns was observed to follow the order of O>B>A>AB,with a significant statistical difference(P<0.01).Of the 123(40.59%)newborns born to mothers of type O,121(98.37%)had blood group antibody titers>2.Of the 20(6.60%)newborns born to mothers of type AB,all 20(100.00%)had blood group antibody titers<2.Among 89(29.37%)mothers of type A and 71(23.43%)mothers of type B,the titer of 100%newborn blood group antibody was less than 2,when the newborn blood group was incompatible with the mother′s blood group;the titer of the newborn blood type antibody was higher or lower,when the newborn blood type was compatible with the mother′s blood type.The titer of the newborn blood group antibodies is related to the number of pregnancies of the mothers and has no association with other clinical data(such as the mother′s number of obortions),the number of production,fetal gestation age.Conclusion:The majority of ABO blood group antibodies in neonates are IgG antibodies from the mothers,and few are produced by the neonates themselves.In some neonates,IgG anti-A and/or anti-B can agglutinate with anti-stereotyped cells at room temperature.The maternal A

关 键 词：新生儿 ABO血型 抗体效价 

分 类 号：R446.6[医药卫生—诊断学]