孕妇IgG血型抗体效价与ABO新生儿溶血病关系分析.doc

孕妇IgG血型抗体效价与ABO新生儿溶血病关系分析 　　【摘要】目的探讨孕妇IgG血型抗体效价与ABO新生儿溶血病发生率之间的关系。方法对716例妻子O型Rh阳性而丈夫非O型孕妇做IgG抗-A（B）效价测定, 对其中106例有HDN危险的孕妇所生新生儿做HDN血型血清学检查。结果716例O型孕妇中IgG抗-A（B）效价64、64、128、256和≥512各组分别占60?9%、22?4%、10?9%、4?2%和1?7%。106例母婴血型不合且有ABO-HDN危险的孕妇所生新生儿中共有24例HDN阳性，占22?6%；孕妇IgG抗-A（B）效价为64、128、256和≥512各组HDN阳性率分别为12?0%、24?1%、38?1%和50?0%（P0?01）。结论孕妇血清中IgG抗-A（B）效价高低与ABO-HDN的发生率成正相关，产前进行血清IgG抗体效价检测非常必要。【关键词】抗体效价 新生儿溶血病 抗-A（B） 　　Study of the relationship between blood group antibody IgG titer of pregnant women and ABO-HDNLI Yan-qiong.Zhumadian Central Hospital,Zhumadian 463000,China【Abstract】ObjectiveTo study the relationship between blood group antibody IgG titer of pregnant women and ABO hemolytic disease of newborn (HDN).MethodsBlood group antibody IgG titers of 716 pregnant women who were O and Rh positive with a non-O husband were detected. After born, blood groups,Coomb,s test,free antibody and antibody release test were done for those 106 babies who were in high risk of HDN.ResultsThe percent of anti-A(B) IgG titer64，64，128，256 and≥512 in the 716 O type pregnant women was 60?9%, 22?4%, 10?9%, 4?2% and 1?7%, respectively. There were 24 babies suffered from HDN in those 106 babies who had high risk,which accounted for 22?6%.With the anti-A(B) IgG titer was 64，128，256 and ≥512, the percent of HDN positive was 12?0 %，24?1%，38?1% and 50?0%, respectively (P0?01).ConclusionThere is a positive relationship between blood group antibody IgG titer of pregnant women and ABO-HDN. It is necessary for the pregnant women to detect the level of anti-A(B) IgG.【Key words】Antibody titer;Hemolytic disease of newborn;Anti-A(B) IgG新生儿溶血病（Hemolytic Disease of New-born,HDN）是由母亲体内存在的与其胎儿红细胞不合的IgG血型抗体而引起的同种被动免疫疾病［1］，严重的可导致流产与新生儿生理缺陷或死亡。在母婴血型不合引起的HDN中，以ABO血型系统最为常见，多发生于O型孕妇所生的A型或B型婴儿，这与O型母亲含抗-A（B）IgG抗体有关。一般认为，孕妇血清中IgG抗-A（B）效价≥64时，胎儿有受害的可能［2,3］，为探讨孕妇血清中IgG血型抗体效价与ABO-HDN发病率之间的关系，我们对716例门诊、住院的O型孕妇做IgG分析，现报告如下。1资料与方法 　　1?1一般资料2008年1月~2009年6月在笔者所在医院作产前血清IgG抗-A（B）效价的孕妇共716例均为妻O型Rh阳性夫非O型孕妇，年龄23~39岁，平均30?1岁，孕周1