孕妇产前抗A(B)IgG效价对高胆红素血症新生儿的影响研究

Effect of prenatal anti-A(B)IgG titer in blood type O mothers on neonatal hyperbilirubinemia

目的探讨孕妇产前抗A(B)IgG效价对高胆红素血症新生儿的黄疸情况及血红细胞参数等指标的影响。方法选取由O型血孕妇生产的且出生后1周内发生新生儿高胆红素血症的足月A(B)型血新生儿174例,按孕妇产前抗A(B)IgG效价分为低值效价组、中值效价组和高值效价组,比较3组新生儿溶血症(HDN)发生率、胆红素指标(TBil、DBil、IBil)、黄疸出现时间、入院治疗开始时间、入院治疗持续时间、血红细胞参数(RBC、Hb、HCT、RDW)和贫血发生率。结果 3组新生儿胆红素指标(T刚、DBil、IBil)均无统计学差异(均P>0.05),但孕妇产前抗A《B)IgG效价越高,HDN发生率越高,黄疸出现时间、入院治疗开始时间越早,入院治疗持续时间越长,RBC、Hb、HcT越低,RDW越高,贫血发生率也增高(均P<0.05)。结论孕妇产前抗A(B)IgG效价可影响新生儿高胆红素血症的发生、发展进程,效价越高,新生儿血红细胞的破坏程度越大。

Objective TO investigate the effects of prenatal maternal anti-A （B） IgG titer on neonatal hyperbilirubinemia. Methods One hundred and seventy four blood type A （B） full-term newborns with neonatal hyperbilirubinemia, who were given birth by blood type O mothers, were enrolled. The rate of hemolytic disease of the newborn （HDN）, bilirubin （TBil, DBil, and IBil） levels, time of jaundice onset, time of admission, length of hospital stay, red blood cell parameters （RBC, Hb, HCT, RDW） and rate of anemia were compared among low, median and high anti-A （B） IgG titer groups. Results There was no significant difference in bilirubin （TBil, DBil and IBil） levels among three groups （P 〉0.05）. However, the higher titer group showed the higher rate of HDN, shorter jaundice onset time and hospital admission time, the longer length of hospital stay, the lower RBC, Hb, HCT levels, the higher RDW and the higher rate of anemia （P〈0.05）. Conclusion Prenatal maternal IgG titer can affect the neonatal hyperbilirubinemia and is positively related to hematolysis.