8207例孕产妇不规则抗体筛查结果分析及临床意义

Clinical significance and results analysis of 8207 pregnant women irregular antibody screening

目的对孕产妇进行血型不规则抗体筛查,探讨孕产妇中单特异性抗体的分布及对输血安全、胎儿、新生儿的影响。方法用微柱凝胶法对2011年1月-2014年12月来我院妊娠保健和分娩的8207例孕产妇进行不规则抗体筛查,筛查阳性标本进一步做抗体特异性鉴定并与同期13 463例非孕产妇患者特异性抗体进行比较。结果在8207例孕产妇中检出不规则抗体38例,其中单特异性抗体33例（以抗-E为主）,自身抗体5例,阳性率为0.46%;非孕产妇患者中检出不规则抗体27例,特异性抗体12例,自身抗体15例,阳性率0.20%,两组比较差异统计学意义（P〈0.05）。妊娠或输血次数越多的孕妇产生同种免疫抗体的风险明显上升。结论孕产妇同种免疫产生的抗体分布以Rh系统为主,最易产生抗-E。对孕妇（特别是有多次妊娠或输血史的孕妇）进行不规则抗体筛查并提早预防治疗,可减少胎儿、新生儿的损害并保障孕产妇输血安全。

Objective To explore the distribution of single specific antibody in pregnant women and the impact on safety of blood transfusions,fetus and newborn by conducting blood type irregular antibody screening to pregnant women. Methods Microcolumn gel test was used to conduct blood type irregular antibody screening to 8207 pregnant women who pregnancy health care and delivery in our hospital from January 2011 to December 2014.Further antibody specificity identification was conducted when specimens screen was positive and compared with 13 463 non pregnant women′s specific antibody at the same period. Results Among 8207 pregnant women,38 irregular antibody was detected.Among that,33 cases were single specific antibody（mainly of anti-E）,5 cases were autoantibody and positive rate was0.46%.Among non pregnant women,27 irregular antibody was detected,12 cases were specific antibody,15 cases were autoantibody and positive rate was 0.20%.By the chi-square test,the difference was statistically significance（P〈0.05）.By investigating pregnancy and blood transfusion history of specific antibody positive maternal found that the pregnant women with more pregnancy or blood transfusion,the risk of producing the same immune antibody increased. Conclusion The antibody distribution of pregnant women conduct same immune antibodies mainly with Rh system and easy to produce anti-E.Conducting irregular antibody screening for pregnant woman（especially for the pregnant woman has a history of multiple pregnancy or blood of pregnant women） and early preventive treatment can reduce the damage to fetal,neonatal and ensure the safety of maternal blood transfusion.