O型孕妇IgG抗A(B)效价对新生儿溶血病的预测价值

The prediction value of serm IgG anti-A(B) titer of pregnant women with blood O in hemolytic disease of the newborn

目的探讨O型孕妇血清中IgG抗A(B)效价与新生儿溶血病的关系。方法应用微柱凝胶法检测504对夫妇血型不合的O型RH(D)阳性孕妇IgG抗A(B)效价,在分娩时采集新生儿脐带血测定ABO、RhD血型、直接抗人球蛋白试验、游离抗体试验和放散试验。结果 504名O型孕妇血清中,IgG抗A(B)效价≤1∶64有265例,1∶128有116例,1∶256有53例,1∶512有41例,1∶1024有29例。其中74名新生儿HDN阳性,经ROC曲线分析,血型抗体最佳临界值为1∶128,此点灵敏度93.2%,特异性66.1%,ROC曲线下面积0.872。结论用微柱凝胶法检测IgG抗A(B)效价,最佳临界值建议为1∶128,对新生儿溶血病的预测价值较高。

Objective To investigate the relationship between the titer of IgG anti- A（B） in pregnant women with blood O and hemolytic disease of the newborn. Methods A total of 504 pregnant women with the O blood group whose husbands were the other blood groups were selected to determine the IgG anti- A（ B） titers by microcolumn gel test. Red blood cells were taken from umbilical vein of the newborns to examine ABO blood groups and RhD blood group. The direct antiglobin test,free antibody test and antibody release test were also carried out on the umbilical vein blood samples from the newborns. Results In the serum of 504 pregnant women with O blood group,IgG anti- A（B） titers≤1∶ 64 was found in 265 cases,IgG anti- A（B） titer was 1∶ 128 in 116 cases,IgG anti- A（B） titer was 1∶ 256 in 53 cases,IgG anti- A（B） titer was 1∶ 512 in 41 cases and IgG anti- A（B） titer was 1∶ 1024 in 29 cases. Seventy- four cases were diagnosed as HDN positive among them. The ROC curve analysis showed the most appropriate cut- off value of IgG anti- A（B） titer was 1∶ 128,with the sensitivity of 93. 2% and specificity of 66. 1%,and the area under curve was 0. 872. Conclusion It is recommended that the cut- off value of IgG anti-A（B） titers for HDN was 1∶ 128 in microcolumn gel test,with higher predictive value in hemolytic diseases of the newborn.