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目的探讨IgG型免疫溶血性贫血红细胞上IgG亚型的分布规律及其与临床疾病的关系。方法从2005—2009年我院确诊为免疫溶血性贫血的患者中,选取46名IgG型直接抗球蛋白试验(DAT)阳性的患者,进一步用免疫沉淀法鉴定其IgG亚型及效价,并结合病史观察其疾病状况及愈后。结果 46名IgG型DAT阳性患者的红细胞上IgG各亚型的阳性率分别为IgG1 91.30%,IgG2 32.61%,IgG3 39.13%,IgG4 26.09%,IgG1与IgG2和IgG4阳性率之间差异有统计学意义(P<0.01),与IgG3之间差异无统计学意义;IgG3亚型效价分布与Hb之间存在负相关,Spearman相关系数为-0.519,而其它3项与之无明显相关性;IgG1和IgG3 2种亚型的效价高低与疗效都无明显相关性。结论 DAT阳性患者的抗IgG型免疫溶血性贫血中红细胞上以IgG1多见,IgG3随着效价的增高所致贫血更为严重。检测IgG亚型的分布并观察其效价的高低,有助于分析贫血的严重程度。
Objective To investigate the distribution of IgG subtypes on IgG-hemolytic anemia erythrocytes and its relationship with clinical diseases. Methods From 46 patients with positive immunoglobulin A (DAT) IgG positive in our hospital from 2005 to 2009, the IgG subtypes and titers were identified by immunoprecipitation Combined with medical history to observe the disease status and prognosis. Results The positive rates of IgG subtypes on 46 erythrocytes were 46.1% IgG1, 32.61% IgG3, 39.13% IgG3, 26.09% IgG4, and the positive rates of IgG1, IgG2 and IgG4 were statistically significant (P <0.01), while there was no significant difference between IgG3 and IgG3. There was a negative correlation between the titer distribution of IgG3 subtype and Hb, Spearman’s correlation coefficient was -0.519, while the other three had no significant correlation with IgG3 There was no significant correlation between the titer of IgG3 subtypes and therapeutic effect. Conclusion DAT-positive patients with anti-IgG-type immune hemolytic anemia in the red blood cells more common IgG1, IgG3 with the increase in potency caused by more severe anemia. Detecting the distribution of IgG subtypes and observing the level of their titer help to analyze the severity of anemia.