11例IgG型免疫溶血性贫血的IgG亚型分布及临床分析

The distribution and clinical analysis of IgG subclasses in 11 immune-mediated hemolytic anemia patients

目的:研究11例IgG型免疫溶血性贫血患者IgG亚型的分类及其效价,评价IgG各亚型的疾病类型、贫血程度及疗效等情况。方法:用抗人球蛋白试验确定11例IgG型免疫溶血性贫血患者,进一步用免疫沉淀法鉴定其IgG亚型及效价,分析IgG亚型的类型及效价与其临床疾病、贫血程度及疗效相关性。结果:11例IgG型AIHA患者中,以IgG1型最为常见,效价多>2430。其中1例为药物诱发所致,2例特发性温抗体自身免疫溶血性贫血(WAIHA)为IgG1型,引起的贫血程度为中等,对激素疗效佳;8例继发性WAIHA患者中,也以IgG1型最为多见,效价多>2430;3例并发含有IgG3亚型患者的贫血较为严重,治疗效果不理想;而IgG4和IgG2亚型者较为少见。结论:分析IgG型免疫溶血性贫血患者的IgG亚型及效价,可作为Coombs′试验的辅助实验,它有助于探讨疾病的发生发展,并有助于分析贫血的严重程度、疗效及预后。

Objective：To Study the distribution and clinical significance of IgG subclasses and their antibody titer of immune-mediated hemolytic anemia. Method：Using Coombs＇ test to diagnose IgG typing immune-mediated hemolytic anemia of 11 patients, then using immune sediment test their IgG sub typing and antibody titer. Analysis IgG sub typing and their clinical disease, anemia level and curative effect. Result：Most patients were IgG1 typing, the titer are more than 2430, one case was indused by drug, 2 cases were idiopathic WAIHA belong to IgG1 typing, the anemia level was moderate and they can be treated by corticosteroid effectively; 8 cases were followed by other diseases, most patients were also IgG1 typing; and three cases include IgG3 typing, the treatment result was not good; the IgG2 and IgG4 typing were very few. Conclusion：Analysis the IgG sub typing and their titer of immune-mediated hemolytic anemia are beneficial for Coombs＇ test, It is good for approaching how the disease hap pen and develop, and it is help for analysis the anemia＇s level, the treatment result and the prognosis.