微柱凝集技术对O型血孕妇IgG抗体效价的检测及意义

Significant of titration of IgG antibody against "O" blood goup in pregnant women by using microcolumn gel coombs′ test

目的检测夫妇血型不合的O型血孕妇血清IgG抗体效价,分析其临床意义。方法用微柱凝胶法抗人球蛋白试验测定224例O型血孕妇IgG抗体效价。结果 (1)224例O型血孕妇中,共检出抗体效价异常者85例(37.9%)。其中妇-夫血型为O-A的94例标本中,异常结果34例(36.2%);妇-夫血型为O-B的91例标本中,异常结果27例(29.7%);妇-夫血型为O-AB的39例标本中,IgG抗A异常24例(61.5%),抗B异常15例(38.5%)。(2)对22例O-A、21例O-B、14例O-AB妇-夫共57例孕妇进行动态检测显示,54例首次检测IgG抗A(B)效价大于或等于1∶64;但动态检测,抗体效价未呈进行性上升,新生儿未出现自身免疫性溶血。1例首次检测抗A 1∶512、抗B 1∶256,动态监测抗体效价先上升后几次监测抗体效价均连续维持在1∶1024,产后出现新生儿溶血症(HDN)。结论微柱凝胶检测对O型血孕妇血清IgG效价进行检测有助于筛选新生儿溶血病高危人群,对高危人群血型抗体定期进行动态监测,可有效减少HDN的发生,降低HDN的损害程度,保证优生优育。

Objective To analysis of IgG anti-A and anti-B titre in serum of pregnant women with blood type O.Methods 224 blood samples of pregnant women with blood type O,whose husbands were of blood type A or B,were detected by microcolumn gel Coombs′ test.Results 85（37.9%） cases abnormity of IgG antibody titre in 224 pregnant women with blood type O 34（36.2%） abnormity of 94 pregnant women in O-A blood type couple group,27（29.7%） abnormity in O-B blood type couple group,24（61.5%） abnormity of anti-A titre and 15（38.5%） abnormity of anti-B titre in 39 pregnant women in O-AB blood type couple group.Detection of IgG anti-A and anti-B titre in serum of pregnant women in 22 cases O-A couple group,21 cases O-B couple and 14 cases O-AB couple group were dynamic analysis.The result shows birth a neonate without hemolytic disease of the newborn（HDN） in 54 cases IgG titre（anti-A or anti B） ≥1∶64 in serum of pregnant women in the first instance without continued increase of IgG titre and a neonate with HDN in anti A titre 1∶512 and anti-B tire 1∶256 in the first with continued increase to 1∶1 024 titre of both anti-A and anti-B IgG titre.Conclusion Detecting titre of blood type antibody IgG in serum of pregnant women with ABO alloimmunization is helpful to diagnose HDN and to instruct.interventions to lower incidence of the disease.Specially,dynamic analysis should be done for pregnant women with high IgG titre of anti-A and/or anti-B.