孕产妇不规则抗体筛查在新生儿溶血病诊断中的应用

Application of Maternal Irregular Antibody Screening for Diagnosis of Neonatal Hemolytic Disease

目的探讨孕产妇不规则抗体筛查在新生儿溶血病中的临床意义。方法采用微柱凝胶抗人球蛋白卡式法对3719例孕产妇进行抗体筛查,对抗体筛查阳性的孕产妇进行抗体特异性鉴定;对抗体筛查阳性孕产妇分娩的新生儿进行新生儿溶血病血型血清学检查及抗体特异性鉴定。结果孕产妇中检出不规则抗体24例,阳性率为0.64%。不规则抗体分布:抗-D13例,抗-M3例,抗-E2例,抗-Ce1例,抗-DC1例,抗-Lea1例,冷自身抗体3例;在24例抗体筛查阳性孕产妇中,发生病理性黄疸并通过血型血清学检测确诊为新生儿溶血病(HDN)新生儿共11例,占45.8%。结论对孕产妇进行不规则抗体筛查在新生儿溶血病的预防、诊断和治疗中具有重要的意义。

Objective To explore the clinical significance of irregular antibody screening of pregnant women in diagnosis of hemolytic disease of newborns.Methods Antibody screening was performed in 3719 pregnant women by microcolumn gel anti-human globulin card method,and antibody specific identification was carried out in those with positive antibodies.Blood type serological examination and antibody specific identification of neonatal hemolytic disease were simultaneously performed.Results Twenty four cases(0.64%)of irregular antibodies were found,including 13 cases of anti-D,3 cases of anti-M,2 cases of anti-E,1 case of anti-Ce,1 case of anti-DC,1 case of anti-Lea and 3 cases of cold autoantibodies.Among the 24 pregnant women with positive antibody screening,pathological jaundice occurred and 11 cases(45.8%)were diagnosed as neonatal hemolytic disease(HDN)by serology of blood grouping.Conclusion Screening of maternal irregular antibodies is of great significance in diagnosis,prevention and treatment of neonatal hemolytic disease.