新生儿溶血病与孕妇产前血型抗体效价水平的相关性分析

Correlation analysis of hemolytic disease of the newborn and pregnant women prenatal blood group antibody titer levels

目的分析O型孕妇产前免疫球蛋白G(Immunoglobulin G,Ig G)血型抗体水平与新生儿溶血病(HDN)相关性。方法选取该院2400例O型Rh血型系统中Rh(D)阳性孕妇进行产前Ig G抗体效价检测,分娩后新生儿血型非O型,Rh血型系统中Rh(D)阳性,进行HDN三项检查。结果 2400名孕妇中Ig G抗体效价<64者1256例,抗体效价≥64者1144例。对2400例新生儿进行溶血病检测,其中703例发生HDN,1697例未发生HDN,HDN的总体发病率为29.3%。在孕妇产前抗体效价<64中有199例发生了HDN,其发病率为15.8%,相对于HDN的总体发病率小;在孕妇产前抗体效价≥64中,有504例发生了HDN,其发病率为44.1%,相对于HDN的总体发病率大,差异有统计学意义(P<0.05)。在产前抗体效价分别为64、128、256、512时,相对应的HDN的发病率为27.8%、37.1%、80.0%、100.0%。结论产前抗体效价越高,HDN发病率越高,且溶血三项皆为阳性的比例更高,O型孕妇产前Ig G抗体效价与HDN发病率成正相关。

Objective To investigate the correlation between prenatal IgG antibody titer of bloodtype O Pregnant woman and hemolytic disease of the newborn(HDN). Methods Detected IgG antibody titer of 2400 cases of pregnant woman, whose bloodtype were O,RH(D)positive. After givebirth,newborn of non-O blood type,Rh blood group system Rh(D)posi-tive,the three HDN test were performed. Results In 2400 pregnant women,the IgG antibody titer were below 64 in 1256 ca-ses,IgG antibody titers were higher than 64 in 1144 cases. Among 2400 cases of neonatal,703 case occurred HDN,1697 cases HDN had not occurred,the overall incidence HDN was 29. 3% . In pregnant women antibody titer ﹤ 64,199 case occurred HDN,the incidence rate was 15. 8% ,lower than overall incidence of HDN;In pregnant women antibody titers ≥64,504 cases occurred HDN,the incidence rate was 44. 1% ,higher than overall incidence of HDN,difference was statistically significant (P ﹤ 0. 05). Prenatal antibody titers were 64,128,256,512,the corresponding incidence of HDN was 27. 8% ,37. 1% ,80. 0%and 100. 0% . Conclusion The higher the prenatal antibody titers,the higher the incidence of hemolytic disease of the new-born,and the more likely all three hemolysis test are positive. The incidence of HDN and IgG antibody titer of bloodtype O pregnant woman are positive correlated.