孕母血型抗体与新生儿ABO溶血病发生的相关性分析

Relationship between ABO hemolytic disease of newborn and maternal antibody

目的探讨产前血型抗体与ABO新生儿溶血病发病(HDN)的相关性。方法对132例O型母亲行产前血型抗体效价检测,新生儿出生后检测血型血清学及胆红素水平,综合评价孕母血型抗体与新生儿ABO溶血病发生的相关性。结果132例夫妻ABO血型不合调查中,O型妻子,A型、B型、AB型丈夫各组发生HDN阳性率分别为38%、38%、26%(P>0.01),无统计学意义;孕妇IgG抗-A(B)效价为≤32、64、1282、56和≥512各组HDN阳性率分别为3%、25%、57%和86%、90%(P<0.01);132例非O型新生儿组血清总胆红素及间接胆红素分别为42.06±15.02μmol/L和34.56±16.82μmol/L,60例O型新生儿组血清总胆红素及间接胆红素分别为33.04±7.3μmol/L和26.99±9.32μmol/L(P<0.05)。结论HDN的发生与丈夫血型无关。孕妇血清中IgG抗-A(B)效价越高,ABO-HDN的发生率越高,且随抗体效价增高而增高。发生HDN,新生儿血清总胆红素及间接胆红素也相应增高。

Objective To study the relationship between ABO hemolytic disease of newborn（ABO-HDN）and maternal antibody.Methods Through measure the titer of blood group antibody during pregnancy in 132 mothers with ＂O＂ blood type,bilirubin and blood group serology in newborn,evaluate the pathogenetic relativity between blood group antibody of mothers and ABO-HDN.Results In 132 cases,different blood group of husband has the similar positive rate in ABO-HDN（P〉 0.01）.The titer of blood group antibody during pregnancy is ≤32,64,128,256 and≥512,the positive rate of ABO-HDN is 3%,25%,57%,86% and 90%（P〈0.01）.Total bilirubin and indirect bilirubin in 132 newborn of ＂non-O＂ group is 42.06±15.02 μmol/L and 34.56±16.82 μmol/L,total bilirubin and indirect bilirubin in 60 newborn of ＂O＂ group is 33.04±7.3 μmol/L and 6.99±9.32 μmol/L（P〈0.05）.Conclusion ABO-HDN has no relationship with the blood type of husband.The positive rate of ABO-HDN is rasing along with the raise of the titer of blood group antibody during pregnancy.The bilirubin is raising when ABO-HDN is happening.