改良Coombs试验测定孕妇IgG抗A（B）效价的临床应用

Determination of Anti-A（B）IgG Titers of Pregnant Women by Improved Coombs Test and Its Clinical Application

目的探讨改良Coombs试验及经典Coombs试验在测定孕妇血清中IgG抗A（B）效价的差异及其临床应用。方法分别用改良Coombs试验和经典Coombs试验测定355例孕妇血清中IgG抗A（B）效价并计算阳性率、特异度和敏感度。结果改良和经典Coombs试验检测孕妇血清中IgG抗A（B）效价的阳性率分别为49．86％和48．73％，两者的差异无统计学意义（P〉0．05）。孕妇血清IgG抗A（B）效价在≤1：32，1：64，1：128，≥1：256时，以经典Coombs试验为标准，改良法的敏感度和特异度分别为99．4％和97．3％。其新生儿溶血病（HDN）发病率分别为1．7％，9．2％，33．9％，55．0％。结论改良和经典Coombs试验检测孕妇血清中IgG抗A（B）效价的检测结果具有良好的一致性，但改良后的检测时间缩短一倍以上，操作更为简单，值得临床推广。同时经研究发现HDN发病率与孕妇血清IgG抗A（B）效价成正相关。

Objective To explore the different of improved and classic Coombs＇test in the determination of anti-A（B） IgG titers and its clinical application. Methods Sera were obtained from 355 pregnant women,Anti-A（B） IgG titers were determined respectively by improved and classic Coombs＇test. The positive rate,sensitivity and specificity of the assays were evaluated. Results The positive rate of Anti-A（B） IgG titers of improved and classic Coombs＇test to detect 355 pregnant women were 49.86% and 48. 73% separately and were not different（P〉0. 05）. Serum anti-A（B） IgG titers were≤1 ： 32, 1 ： 64,1 ： 128,≥1 ： 256 as the incidences of hemolytic disease of the newborn（HDN） were 1.7% ,9.2% ,33.9%,55.0% respectively in the 355 pregnant women. The sensitivity and specificity of improved Coombs＇test were separately 99.4 % and 97.3%. Conclusion The improved and classic Coombs＇test show the incidence of HDN is positively correlated to anti- A（B） IgG titer in pregnant women.