孕妇产前IgG血型抗体效价测定及临床应用

The clinical application of prenatal serum blood group IgG antibody titer determination

目的观察孕妇产前体内IgG血型抗体水平及与新生儿溶血病的关系。方法采用微柱凝胶抗人球蛋白卡法对255例夫妇进行产前IgG血型抗体效价及ABO血型测定。结果在对195例夫妇ABO血型不合调查中,IgG血型抗体水平异常(≥64)阳性率为93.8%。其中IgG抗A(B)效价:<64为12例(6.2%),64为12例(6.2%),128为60例(30.8%),256为39例(20%),512为45例(23.0%),1 024为27例(13.8%)。丈夫/孕妇血型组合为A/O与丈夫/孕妇血型组合为B/O两组间IgG抗体检出率比较,差异无统计学意义(χ2=4.361,P=0.499),AB血型的父亲其妻子抗体效价更高。结论对夫妇ABO血型不合孕妇产前IgG血型抗体效价测定有助于新生儿溶血病的产前预测,以利于尽早采取有效预防、治疗,减少新生儿溶血病的发病率,对于人口优生方面具有重要意义。

Objective To assess the relationship between the serum IgG antibody titer of pregnant women and the hemolytic disease of newborn（HDN）.Methods Using microcolumn gel coombs card assay method to determine titer of 255 cases of couples antenatal serum IgG antibody and ABO blood group.Results with 195 cases of ABO-incompatible couples,the positive rate of abnormal serum IgG antibody（≥64）was 93.8%.The titer of anti-A/B IgG：in 12（6.2%）cases was〈64;in 12（6.2%）cases was 64;in60（30.8%）cases was 128;in 39（20%）cases was 256;in 45（23.0%）cases was 512;in 27（13.8%）cases was 1 024.There were no statistical differences between IgG anti-A（B）titers distribution between A/O blood group matching and B/O blood group matching（χ2=4.361,P=0.499）,IgG anti-A（B）titers was higher in AB/O blood group matching.Conclusion we can take early and effective prevention,treatment,reducing the incidence of HDN by the determination of prenatal serum IgG antibody titers in ABO-incompatible couples,which is important for the population of eugenics.