新生儿ABO溶血病患儿红细胞检测其血液中IgG亚型的应用

Application of red blood cell in the detection of lgG subtype in the blood of neonates with ABO hemolytic disease

目的利用ABO溶血病患儿红细胞和IgG亚型试剂检测患儿血液中IgG亚型分布,探究其与患儿发生高胆红素血症的关联。方法采用新生儿溶血病血型血清学检查检测新生儿ABO溶血病;用2种红细胞与IgG亚型试剂检测患儿血液中IgG亚型;全自动生化分析仪检测患儿血清胆红素值。结果检出新生儿ABO溶血病197例,其中检出IgG各亚型86例,IgG1、IgG2、IgG3、IgG4、IgG1-IgG4混合亚型各组高胆红素血症的发生率分别为59.2%、7.7%、100.0%、0.0%、14.3%。高胆红素血症患儿中,以红细胞直接抗球蛋白试验和血清游离抗体测定阳性者最高,红细胞直接抗球蛋白试验阳性和血清游离抗体测定阴性者次之,红细胞直接抗球蛋白试验和血清游离抗体测定均阴性者不发生高胆红素血症。结论利用新生儿ABO溶血病患儿红细胞检测其血液中IgG亚型分布,并结合直接抗球蛋白试验和游离抗体测定结果来预测患儿发生高胆红素血症的几率,是目前较为理想的方法。

Objective To detect the distribution of IgG subtype in blood of children with ABO hemolytic disease by red blood cell and IgG subtype reagent,and to explore the association with neonatal hyperbilirubinemia. Methods Serological examination was performed on ABO hemolytic disease of the newborn. IgG subtype in blood of children was detected with two kinds of red cells and IgG subtype reagent. Serum bilirubin levels in children were tested with automatic biochemistyanalyzer.Results 197 case of neonates with ABO hemolytic disease were detected,among which 86 cases with IgG subtype expression were detected. The incidence rates of hyperbilirubinemia in IgG1,IgG2,IgG3,IgG4,IgG1- IgG4 subtyp groups were respectively 59. 2%,7. 7%,100. 0%,0. 0%,14. 3%. In patients with hyperbilirubinemia,the highest incidence of hyperbilirubinemia was on those with positive results of direct antiglobulin test and free antibody test,followed by those with positive direct antiglobulin test result and negative free antibody test result. The direct antiglobulin test and free antibody test showed that hyperbilirubinemia didn＇t happen in the group with negative test results. Conclusion The detection of IgG subtypes distribution with the red cells in children with ABO hemolytic disease,combined with the direct antiglobulin test and free antibody assay results,is an ideal method to predict the incidence rate of hyperbilirbinemia in the new born.