孕妇IgG型抗-A/抗-B抗体效价与新生儿溶血病发生率的相关性

Relationship between Anti-A / Anti-B IgG Titer of Pregnant Women and Morbidity of Hemolytic Disease of Newborn

目的分析孕妇血清中IgG型抗-A/抗-B抗体效价与母婴血型不合引起的ABO新生儿溶血病(Haemolytic diseaseof the newborn,HDN)发生率的相关性,为HDN的早期诊断和预防提供依据。方法对2005～2008年广州市番禺区各医院送检的1 425份标本和花都区人民医院送检的300份标本(孕妇血型为O型,丈夫为非O型)进行IgG型抗-A/抗-B效价测定,并追踪新生儿HDN的发生情况,分析二者的相关性。结果 1 725份标本抗体筛选试验均未检出同种特异性血型免疫抗体;IgG型抗-A/抗-B抗体效价在16以上的有334份样本,其中有146例于产后1～3 d发生HDN,HDN的发生率随着孕妇IgG型抗-A/抗-B抗体效价的上升而升高,也有个别孕妇IgG型抗-A/抗-B抗体效价高达1 024,但新生儿未发生HDN。结论广州市番禺区和花都区孕妇血清中IgG型抗-A/抗-B抗体效价与HDN的发生密切相关,产前进行IgG型抗-A/抗-B抗体效价测定可预先判断HDN的发生。

Objective To analyze the relationship between anti-A / anti-B IgG titer in sera of pregnant women and the morbidity of haemolytic disease of the newborn（HDN） due to maternal and neonatnat blood group incompatibility,and provide a basis for early diagnosis and prevention of HDN.Methods The serum samples from the pregnant women of blood group O,whose husbands were not of blood group O,were collected,including 1 425 from various hospitals in Panyu District and 300 from People′s Hospital of Huadu District in Guangzhou City,and determined for anti-A / anti-B IgG titer,based on which the morbidity of HDN was followed up,and the relationship was analyzed.Results No homologous specific blood group antibodies were detected in the 1 725 samples.A total of 146 cases of HDN were observed in the infants aged 1 ～ 3 days delivered by the 334 pregnant women with serum anti-A / anti-B IgG titers of more than 16.The morbidity of HDN increased with the increasing anti-A / anti-B IgG titers of pregnant women.However,though the IgG titers of individual pregnant women reached 1 024,no HDN was observed in their infants.Conclusion The anti-A / anti-B IgG titers in sera of pregnant women in Panyu and Huadu Districts of Guangzhou City were closely related to the morbidity of HDN which might be predicted by prenatal determination of anti-A / anti-B IgG titers in sera.