孕妇产前不规则抗体筛查在新生儿溶血病预防中的意义

The Significance of Prenatal Screening for Irregular Antibodies in the Prevention of Hemolytic Disease of Nerborn

目的检测孕妇产前IgG抗A/B抗体效价,探讨孕妇产前不规则抗体筛查在新生儿溶血病预防中的意义。方法对317例夫妻血型不合的孕妇进行产前抗A/B IgG抗体效价测定,并对IgG类抗A/B效价≥1:64的孕妇给予临床干预,观察产后婴儿是否发生溶血,溶血出现的时间及程度;同时随机选择317例夫妻血型不合,产前未做不规则抗体筛查的产妇,调查其婴儿是否发生溶血,溶血出现的时间及程度。结果①试验组,新生儿溶血发生13例(4.10%),其中24 h内发生者1例,48 h发生者3例,72 h发生者3例,>72 h发生者6例;对照组,新生儿溶血发生49例(15.46%),其中24 h内发生者14例,48 h发生者17例,72 h发生者15例,>72 h发生者3例;两组比较有统计学意义(P<0.05);②对照组新生儿黄疸平均出现时间(53.39±26.95)h;试验组(77.54±29.64)h,试验组新生儿黄疸出现时间较对照组晚;③对照组黄疸程度较试验组严重的,两组比较差异有统计学意义(P<0.05)。结论孕妇产前ABO血清IgG抗A/B抗体效价测定可作为判断胎儿出生后是否发生新生儿溶血病的筛查指标。对降低新生儿母婴血型不合引起的新生儿溶血病具有积极作用。

Objective The purpose of prenatal detection of IgG anti-A/B antibody titers to explore prenatal screening for irregular antibodies in the prevention of hemolytic disease of newborn significance. Methods 317 cases of pregnant women detected for prenatal anti-A/B IgG antibody titer of couple＇ s blood type incompatibility,and IgG anti-A/B titer ≥ 1：64 to administrate clinical interventions for pregnant women to observe the occurrence of post-natal baby hemolysis, hemolysin appears time and level; at the same time 317 cases of randomly selected couples blood group incompatibility, prenatal screening not done irregular maternal antibodies to investigate whether their infants hemolysis, hemolytic emerging time and extent. Results （1）In the experimental group, 13 cases of neonatal hemolytic occurred （4. 10% ）, which occurred within 24 h was one ease ,48 h occurred in 3 cases ,72 h occurs 3 cases, 〉 72 h were 6 eases occurred; control group ,49 oceurrod in neonatal hemolytic cases（ 15.46% ） ,which occurs within 24 h of 14 cases,48 h occurs 17 cases,72 h occurred in 15 cases, 〉72 h were 3 cases occurred; two groups was statistically significance （P 〈 0. 05 ）. （2）In the experimental group ,average time appearing of jaundice was（77. 54 ±29. 64）h; control group, （53.39 ±26. 95）h,the experimental group is later than control group ;（3）The degree of jaundice in the control group was severer than experimental group, two groups was statistically significance（ P 〈 0. 05 ）. Conclusion ABO prenatal serum IgG anti- A/B antibody titer determination as to determine whether the fetus after birth occurred in hemolytic disease of newborn screening indicators. To reduce maternal and child neonatal ABO hemolytic disease of newborns caused by having a positive effect.