母体IgG抗体效应检测对新生儿溶血发生风险的预测价值

Predictive Value of Maternal IgG Antibody Titer Test for the Risk of Hemolytic Disease of the Newborn

目的 探讨O型血孕妇IgG抗体效价检测对新生儿溶血病（HND）的诊断价值.方法 选取2013年1月—2016年2月定期产前检查O型RhD阳性血型孕妇822例,检测孕妇血清IgG抗A（B）抗体效价,分析IgG抗A（B）抗体效价与HND的关系.结果 妊娠次数≥2次产妇IgG抗A（B）抗体阳性率和HDN发生率分别为54.05%和27.13%,均明显高于孕次为1次的产妇,差异有统计学意义（P〈0.05）;随着孕妇血清IgG抗A（B）抗体效价的增加,HDN发生率有增加的趋势（P〈0.05）,其中效价为1：512时HDN的发生率达到84.62%;IgG抗A（B）抗体效价与HDN患儿血清间接胆红素水平呈正相关（r=0.365,P〈0.05）.结论 母体IgG抗体效价在预测HDN发生中有一定的价值,且与患儿血清间接胆红素水平有关.

Objective To explore the diagnostic value of IgG antibody titer detection of O type pregnant women in hemolytic disease of the newborn （HND）. Methods From January 2013 to February 2016, 822 cases of pregnant women with O type RhD positive who were examined regularly in our hospital were selected, to detect serum IgG anti A （B） antibody titer in pregnant women and to analyse the relationship between IgG anti A （B） antibody titer and HND. Results IgG anti A（B） antibody positive rate in pregnancy ≥ 2 times maternal and HDN incidence rate were 54.05% and 27.13%, significantly higher than those of pregnancy 1 time, the difference was statistically significant （P〈0.05）; With the increase of IgG anti A （B） antibody titer in pregnant women, the incidence of HDN was increased （P〈0.05）, the occurrence rate of HDN in titer 1：512 was 84.62%; The titer of IgG anti A （B） antibody was positively correlated with serum indirect bilirubin level in HDN （r=0.365, P〈0.05）. Conclusion Maternal IgG antibody titer has a certain value in predicting the occurrence of HDN, and is related to the level of indirect bilirubin in the serum of HDN children.