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目的分析O型血孕妇免疫性抗体(IgG抗体)效价与新生儿溶血病(HDN)发病率及溶血程度的关系。方法使用微柱凝胶法检测蚌埠市第一人民医院512例O型孕妇产前IgG抗体效价,产后收集新生儿静脉血采用微柱凝胶卡式法和全自动生化分析仪检测新生儿的溶血三项和血清总胆红素,分析IgG抗体效价与HDN发病率及溶血程度的关系。结果免疫性抗体孕妇的HDN总发病率为15.6%(80/512);孕妇IgG抗体效价为1∶64、1∶128、1∶256、1∶512时,HDN的发病率分别为14.0%(12/86)、22.6%(14/62)、34.2%(26/76)、43.8%(28/64),与正常抗体效价组相比(<1∶64),差异均有统计学意义(P<0.005),其血清总胆红素虽有升高,但各组间差异无统计学意义(P>0.05)。孕妇免疫性抗体效价与HDN发病率呈正相关,但与HDN溶血程度无相关。结论孕妇产前免疫性抗体效价检测可预估新生儿溶血病(HDN)发生率,免疫性抗体效价异常的孕妇应及早干预治疗,有助于降低新生儿发生HDN的风险。
Objective To analyze the relationship between the titer of immune antibody (IgG antibody) in pregnant women with type O blood and the incidence of hemolytic disease (HDN) and hemolytic disease. Methods The microcolumn gel method was used to detect prenatal IgG antibody titres in 512 O-pregnant women in First People’s Hospital of Bengbu. Neonatal venous blood samples were collected after delivery. Micro-column gel card method and automatic biochemical analyzer were used to detect neonatal Hemolytic three and serum total bilirubin, analysis of IgG antibody titer and the incidence of HDN and hemolytic levels. Results The overall incidence of HDN in immunized pregnant women was 15.6% (80/512). The IgG antibody titer of pregnant women was 1:64, 1:128, 1:256 and 1:512, the incidence of HDN was 14.0% (12/86), 22.6% (14/62), 34.2% (26/76) and 43.8% (28/64), respectively, which were significantly different from the normal antibody titers (<1:64) (P <0.005), although the serum total bilirubin increased, but there was no significant difference between the groups (P> 0.05). Immune antibody titers of pregnant women were positively correlated with the incidence of HDN, but no correlation with HDN hemolysis. Conclusion Prenatal immune antibody titer test can predict the incidence of neonatal hemolytic disease (HDN), pregnant women with abnormal immunoglobulin titers should be treated as soon as possible and help to reduce the risk of neonatal HDN.