新生儿Rh溶血病与IgG1、IgG3相关性分析

Correlation analysis between neonatal Rh hemolytic disease and IgG1 and IgG3

目的研究Rh血型系统新生儿溶血病与IgG1、IgG3的相关性。方法研究Rh-HDN患儿64例。新生儿出生后抽取患儿及其母亲外周静脉血,检测患儿母亲Rh系统抗体、患儿IgG亚型以及血清总胆红素、间接胆红素水平,分析患儿不同IgG亚型与其血清总胆红素、间接胆红素水平的相关性,并分析不同Rh系统抗体对患儿血清总胆红素、间接胆红素水平的影响。结果 Rh系统抗-D占65.63%,抗-E(包括Rh-E、Rh-cE)占26.56%,引起新生儿Rh-HDN发病的IgG抗体亚型主要为IgG1(23例,35.94%)、IgG1、3(35例,54.68%)两类。IgG1、3组患儿血清总胆红素、间接胆红素水平明显高于IgG1或IgG3组(P<0.05)。Pearson相关性分析显示:患儿血清总胆红素、间接胆红素水平与患儿IgG1水平和IgG1、3水平呈显著正相关(P<0.05),与患儿IgG3水平无显著相关性;抗-D组患儿血清总胆红素、间接胆红素水平明显高于非抗-D组(P<0.05)。结论新生儿Rh溶血症患儿黄疸严重程度与IgG水平呈显著正相关,对于疑有Rh溶血症的患儿,进行IgG1或IgG1、3水平的检测,对该类患儿早期治疗有指导意义。

Objective To study the correlation between hemolytic disease and IgG1 and IgG3 in Rh blood group system. Methods The subjects were Rh-HDN children. The newborn venous blood of the child and its mother was taken after birth,and the mother Rh system antibody,the IgG subtype of the child,the serum total bilirubin and the indirect bilirubin level were detected,and the different IgG subtypes and serum totals were analyzed. The correlation between bilirubin and indirect bilirubin levels,and the effects of different Rh system antibodies on serum total bilirubin and indirect bilirubin levels in children. Results Anti-D of Rh system accounted for 65.63%,anti-E (including Rh-E,Rh-cE) accounted for 26.56%,and the IgG antibody subtype of neonatal Rh-HDN was mainly IgG1 (23 cases,35.94%),IgG1,3 (35 cases,54.68%) two categories. Serum total bilirubin and indirect bilirubin levels were significantly higher in IgG1 and 3 groups than in IgG1 or IgG3 groups ( P <0.05). Pearson correlation analysis showed that there was a significant positive correlation between serum total bilirubin and indirect bilirubin levels and IgG1 levels and IgG1 and 3 levels ( P <0.05),and no significant correlation with IgG3 levels in children. Serum total bilirubin and indirect bilirubin levels were significantly higher in the anti-D group than that in the non-anti-D group ( P <0.05). Conclusion The severity of jaundice in neonates with Rh hemolytic disease is significantly positively correlated with IgG level. For children with suspected Rh hemolytic disease,IgG1 or IgG1 and 3 levels are detected,which is helpful for early treatment of this type of children.