抗D免疫球蛋白在Rh阴性血型孕产妇中的应用效果

Application effect of anti-D immunoglobulin on Rh negative blood pregnant women

目的探讨注射抗D免疫球蛋白在Rh阴性血型孕产妇中的应用效果。方法选择2016年1月~2017年11月北京市海淀区妇幼保健院共就诊119例Rh阴性血型孕产妇,将孕28周自行注射抗D免疫球蛋白的33例孕妇作为抗D免疫球蛋白注射组(实验组),随机抽取未注射抗D免疫球蛋白的Rh阴性血型孕妇33例作为对照组。应用戴安娜微柱凝胶抗人球蛋白检测卡,对Rh阴性血型孕产妇的抗D抗体进行检测,使用试管法确定RhD血型,两组数据运用统计学分析其差异性。结果实验组和对照组的产后出血量、新生儿感染,早产、死胎、新生儿贫血比较,差异无统计学意义(P>0.05)。分娩方式、新生儿RhD阴性比例、新生儿高胆红素血症两组比较,差异有统计学意义(P<0.05)。结论 Rh阴性血型孕产妇注射抗D免疫球蛋白是避免发生同种免疫产生抗D抗体的一种有效的方法,使Rh同种免疫的发生率下降,在我国对孕产妇使用抗D免疫球蛋白的管理有待完善。

Objective To dicuss the application effect of anti-D immunoglobulin on Rh negative blood pregnant women.Methods From January 2016 to November 2017, in Haidian District Maternal and Child Health Care Hospital, 119 pregnant women with Rh negative blood were selected, 33 pregnant women injected with anti-D immunoglobulin by themselves at 28 weeks of pregnancy were as the injected anti-D immunoglobulin group（experiment group）, and 33 randomly selected from 86 pregnant women not received anti-D immunoglobulin were as the control group. The antihuman globulin detection card of Diana microcolumn gel was applied to test the anti-D antibody of the Rh negative blood pregnant women, and the Rh D blood type was tested by test tube method, and the difference of two groups were statistically analyzed. Results The postpartum hemorrhage, neonatal infection, premature birth, stillbirth and neonatal anemia of experiment group and control group were compared, the differences were not statistically significant（P〈0.05）. The mode of delivery, proportion of Rh-negative newborns, neonatal hyperbilirubinemia of two groups were compared, the differences were statistically significant（P〈0.05） Conclusion Injecting anti-D immunoglobulin is an effective way to avoid alloimmunization to produce anti-D antibody, it can reduce incidence of Rh immunosuppression, the management of anti-D immunoglobulin in our country needs to be improved.