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785例,共分娩新生儿794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;③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、总胆红素及其分型等。【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,但差异无显著性(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,但差异无显著性(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0.756(P<0.05);而新生儿溶血性贫血的发生率与母亲抗体效价无相关(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惟一诊断依据,有条件者可进一步做脐血或羊水胎儿血型物质及胆红素的测定。
[Objective] To study the relationship between IgG antibody titer and ABO hemolytic disease of newborn. [Methods] A total of 785 gestational women with O blood group whose husbands were the other blood group except O and 794 newborn were chosen. Serum IgG antibody against A and B of red blood cells of pregnancy women was examined. The efficiency≥1 ： 64 were positive, and reexamination was done in time during pregnancy. Red blood cells were taken from umbilical vein to do the following four examinations when delivery：①blood type; ②coomb＇s test; ③free antibody detection; ④liberation test. The newborns diagnosed as ABO haemolytic disease were examined for their red blood cells, Hb, net blood cell, total bilirubin and type. [Results] The positive rate of AbA and AbB of the gestational women with more than one time pregnancy was higher than that with only one pregnancy. The difference was significant （ P 〈0.05）. The positive rate of the eider women was higher than that of the younger Women, but the difference wasn＇t significant （ P 〉0.05）. Comparing between the newborns with O blood group and others with A or B blood group, IgG antibody titers of their mothers were supplied differently, but the difference wasn＇t significant （ P 〉 0.05）. The incidence of haemolytic disease of newborn increased when IgG antibody titer against A and B increased. The correlation coefficient was 0. 756 （ P 〈0.05）, but the incidence rate of haemolytic disease of the newborn did not increase when the antibody titer increased （ P 〉0.05）. [Conclusion]The pregnant women who have many times of pregnancy, and are elder or have history of abnormal pregnancy should be examined for the titer of IgG antibody against A and B in the early period of pregnancy. Dynamic observation should be taken during pregnancy. Serum IgG antibody titer in maternal serum should not be the only evidence for diagnosing fetal haemolytic disease and its prognosis. Therefore it is necessary to measure amniotic fluid or umbilical blood and the level of bilirubin, and to examine the blood type and to do the diagnostic test for the conditioned person.
出处
《医学临床研究》
CAS
2008年第6期1028-1030,共3页
Journal of Clinical Research
