摘要
目的探讨母亲孕期血型血清学的IgG抗体效价与新生儿ABO溶血的关系。方法选择血型为“O”型、其丈夫血型为非“O”型的孕妇379例,共分娩新生儿383例,孕妇进行血清红细胞抗A及抗B的IgG抗体测定,效价≥1:64者为阳性,孕期给予定期复查,分娩时取脐静脉血做红细胞四项试验:①血型;②直接抗人球蛋白试验;#$游离抗体检测;④释放试验。新生儿确诊为母儿ABO血型不合溶血者,测定其红细胞、血红蛋白、网织红细胞、总胆红素及其分类等。结果2次及以上妊娠孕妇的抗A、抗B阳性率大于1次妊娠者,差异有显著性,P<0.05;年龄较大孕妇的抗A和抗B抗体阳性率高于年轻组,但无显著性差异,P>0.05;血型为O型的新生儿与A、B型的新生儿,其母亲IgG抗体抗A或抗B抗体效价分布不同,但无显著性差异,P>0.05;母亲IgG抗A或抗B抗体效价与新生儿ABO溶血的发生率相关,相关系数为0.8216,P<0.05:而新生儿溶血性贫血的发生率与母亲抗体效价不相关,P>0.05。结论对妊娠次数较多、年龄较大或有不良生育史的孕妇在孕早期即应进行抗A(B)IgG抗体效价的测定,整个孕期动态观察,但不能单纯以孕妇血清抗体效价的高低作为判断胎儿溶血及预后是否严重的唯一诊断依据,有条件者可进一步行脐血或羊水血型物质、确诊试验及胆红索的测定。
Objective To study the relationship between the efficiency of the IgG antibody by the maternal-fetal blood group incompatibility and ABO haemolytic disease of the newborn. Methods Choosed 379 gestational women with the O blood group whose husbounds with the other blood group except O.There were born 383 newborn.The women were examined the IgG antibody to AbA and AbB of red blood cell in the maternal serum.The efficiency≥ 1：64 was （＋）,recheck in time during the pregnancy,and taking the red blood cell from umbilical vein to do the four examinations when delivery： ①the blood group. ② coomb＇s test. ③free antibody detection. ④liberation test.The newborn diagnosed to be ABO haemolytic disease were examined their red blood cell, Hb, net blood cell, total bilirnbin and its types. Results The rate of （＋） for the AbA ,AbB of the gestational women with more than one time pregnancy was higher than those with only one pregnancy.The difference was significant, P〈0.05;the elder was higher than the younger, but the difference wasn＇t significant, P〉0.05; Comparing with the newborn with the O blood group and others with the A or B bloodgroup,the IgG antibody＇s efficiency of their mother was supplied differently, but difference wasn＇t significant, P〉0.05. The haemolytic disease of the newborn will increase when the AbA and AbB IgG antibody＇s efficiency increase.The correlaional was 0.8261, P〈0.05, but the incidence rate of the haemolytic disease of the newborn do not increase when the antibody＇s efficiency increase, P〉0.05. Conclusions The pregnant women who have many times of pregnancy, who are elder or have unnomal pregnancy before must be examined the AbA and AbB IgG antibody＇s efficiency in the early period of pregnancy. Looking over that all the pregnant,but fetal women haemolytic disease can not be diagnosed only by serum IgG antibody＇s efficiency of pregnant women.The one can also take the amniotic fluid or umbilical blood to examinate the blood type ,the level of bilirnbin,and diagnosed test.
出处
《中国现代医药杂志》
2006年第4期7-10,共4页
Modern Medicine Journal of China
关键词
ABO血型不合
妊娠
溶血
ABO blood type unmatching
Pregnancy
Hemolysis
