不同抗体效价检测方法评估新生儿溶血病及其参考值的确认

Prediction of the hemolytic disease of newborns and confirmation of reference values by different antibody titer detection methods

目的:探讨凝聚胺法、经典抗人球法、凝胶卡法检测抗体效价与HDN发生率之间相关性,并制定疑似病例参考值.方法:采用三种方法检测489例ABO血型不符的O型孕妇IgG抗-A、抗-B、抗-AB效价,观察抗体分布情况、抗体效价与新生儿溶血病发生的相关性,根据发病率判断每种检测方法的参考值.结果:489例孕妇所生新生儿发生HDN有29例,发病率为5.93%,随着抗体效价增高,HDN发生率逐渐增高,凝聚胺法检测效价≤32均未发生HDN,经典抗人球法检测效价≤64均未发生HDN,凝胶卡法检测效价≤128均未发生HDN,ABO-HDN发生率与妊娠次数无明显相关.结论:凝聚胺法检测抗体效价可以用≥64作为疑似ABO-HDN诊断标准,经典抗人球法检测抗体效价可以用≥128作为疑似ABO-HDN诊断标准,凝胶卡法检测抗体效价可以用≥256作为疑似ABO-HDN诊断标准.

Objective To investigate the correlation between antibody titer(detected by polybrene test,classical antihuman globulin test and microcolumn gel test respectively)and HDN(hemolytic disease of the newborn)incidence rate,so as to establish reference values for suspected cases.Methods Three methods were used to detect the IgG anti-A/B titer of 489 pregnant women with O blood who have problem of ABO blood group incompatibility,so as to observe the distribution of antibody,the correlation between antibody titer and HDN,and to judge the reference value through each detection method according to the incidence rate.Results There were 29 cases of HDN in 489 pregnant women,the incidence rate was 5.93%.With the increase of antibody titer,the incidence of HDN increased gradually.There was no HDN when antibody titer detected by the polybrene test≤32,the classical antihuman globulin tes≤64 and the microcolumn gel test≤128.The incidence of ABO-HDN was not significantly correlated with the number of pregnancies.Conclusion Antibody titer≥64 detected by the polybrene test,antibody titer detected by the classical antihuman globulin test≥128 and antibody titer≥256 detected by the microcolumn gel test can be used as the diagnostic standard for suspected ABO-HDN.