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目的研究O型血孕妇产前IgG抗-A(B)血型抗体的效价对新生儿红细胞致敏情况,以预防新生儿溶血病的发生。方法采用抗人球蛋白法检测723例丈夫为非O型的O型血孕妇IgG抗-A或抗-B的ABO血型抗体效价,分娩时取脐静脉血做红细胞四项试验:血型、直接抗人球蛋白试验、游离抗体检测、释放试验。结果 723份血清中IgG抗-A(B)效价≥1∶64者有168例,异常检出率为23.24%;丈夫为A型、B型、AB型者,IgG抗-A(B)异常检出率分别为26.01%、20.13%、23.53%。当孕妇IgG抗-A(B)效价≤32时,新生儿血清学检验结果均为阴性,而效价为64、128、256、≥512新生儿脐血血清学检验结果阳性率分别为7.69%、64.29%、94.12%、100.00%。结论孕妇IgG抗-A(B)效价与新生儿红细胞致敏呈正相关,是产前预报母子血型不合而引起HDN的有效方法。可及早发现,及时治疗,减少由于母婴血型不合引起的溶血病发生。
Objective To study the sensitization of prenatal IgG anti-A (B) blood group antibody in O-type pregnant women to neonatal erythrocytes to prevent neonatal hemolytic disease. Methods The anti-human globulin method was used to detect the antibody titer of anti-A or anti-B ABO antibody of 723 pregnant women with non-O-type her husband. The blood samples were taken from the umbilical venous blood for four types of red blood cells during pregnancy: Anti-human globulin test, free antibody test, release test. Results There were 168 cases of IgG anti-A (B) titer≥1: 64 in 723 serums and the rate of abnormality was 23.24%. The husbands were type A, B and AB, IgG anti-A The abnormal detection rates were 26.01%, 20.13% and 23.53% respectively. Serum test results of neonates were all negative when the titer of IgG anti-A (B) was less than 32 in pregnant women, while the titer was 64,128,256. The positive rates of cord blood serology in ≥512 newborns were 7.69 %, 64.29%, 94.12%, 100.00%. Conclusion The IgG titer of anti-A (B) in pregnant women is positively correlated with the erythrocyte sensitization in neonates. It is an effective method to predict the HDN caused by prenatal maternal blood group incompatibility. Early detection and timely treatment can reduce the occurrence of hemolytic disease due to maternal and child blood group incompatibility.