孕妇红细胞血型不规则抗体检测的临床意义

Irregular antibodies detection of RBC blood type in pregnant women

目的 检测孕妇红细胞血型不规则抗体，了解其阳性率及分布，探讨不规则抗体检测在诊断非ABO系统胎儿及新生儿溶血病（HDN）中的应用价值。方法 使用DIANA全自动血型仪检测3000例孕妇血浆标本中的不规则抗体，阳性者鉴定抗体特异性、免疫球蛋白类型及效价，并对阳性者的新生婴儿采脐带血做HDN检测。结果 3000例孕妇不规则抗体阳性15例（阳性率为0．5％），抗体特异性分别为抗-E3例、抗-C2例、抗-Ec1例、抗-M3例、抗-Le^a1例、抗-Fy^a1例。另4例与所有红细胞和自身细胞均成阳性反应，未能确定其特异性。4例新生儿红细胞被来自母体的不规则抗体致敏，分别为抗-E2例、抗-C1例、抗-M1例。结论 检测孕妇不规则抗体对诊断非ABO系统HDN具有十分重要的应用价值。

Objective To study the clinical value of irregular antibodies of RBC blood type in pregnant women on diagnosing non- ABO hemolytic disease of newborn （non -ABO HDN）. Methods 3000 cases of pregnant women were detected with Coombs test for irregular antibodies. The positive cases were identified for antibodies specificity, immunoglobulin types and titer. And cord blood of the pregnant women when they delivery were took to detected HDN. Results Fifteen of the 3000 pregnant women were positive in irregular antibody detecting （the positive ratio was 0.5% ）. Eleven cases were detected out specific irregular antibodies as following： 3 cases of anti - E, 2 cases of anti - c, 1 case of anti - Ec, 3 cases of anti - M, 1 case of anti - Lea, 1 case of anti - Fya. The other 4 cases presented positive results in reaction with all types of RBC and cells of itself and could not define irregular antibody specificity. RBC of 4 newborns was sensitized by irregular antibodies from mothers which were as follows ： 2 cases of anti - E, 1 case of anti - c, 1 case of anti - M. Condusion Irregular antibody detection of pregnant woman has important clinical value in diagnosing non - ABO HDN.