动态监测方法预防新生儿溶血病研究

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目的:动态监测O型血孕妇不同孕期血清IgG抗A(B)效价,为预防新生儿ABO溶血病(HDN)的发生提供治疗依据。方法:以微柱凝胶法对480例O型血孕妇进行孕期IgG抗A(B)效价的动态监测,观察IgG抗A(B)抗体效价的分布范围、变化情况及新生儿溶血病发生率。结果:在所检测的480例O型血孕妇中孕早期IgG抗A(B)效价<1∶64有429例,IgG抗A(B)效价≥1∶64有51例,异常发生率为10.6%;孕中期IgG抗A(B)效价<1∶64有369例,IgG抗A(B)效价≥1∶64有111例,异常发生率为23.1%;孕晚期IgG抗A(B)效价<1∶64有311例,IgG抗A(B)效价≥1∶64有169例,异常发生率为35.2%,比较具有显著差异性(P<0.05)。在169例IgG抗A(B)效价≥1∶64孕妇中生出HDN患儿62例,HDN发生率为36.7%,在其他311例IgG抗A(B)效价<1∶64孕妇中生出HDN患儿28例,HDN发生率为9.0%,两者比较具有显著差异性(P<0.05),O/A、O/B比较无显著性差异。结论:HDN的发病率随着母体内的IgG抗A(B)抗体水平增高而增大,动态监测O型血孕妇不同孕期血清IgG抗A(B)效价十分必要,可以更加准确预测ABO溶血病发生,及早进行预防。 OBJECTIVE: To dynamically monitor serum IgG anti-A (B) titer in pregnant women with O-type blood during pregnancy to provide therapeutic evidence for the prevention of neonatal ABO hemolytic disease (HDN). Methods: The dynamic monitoring of IgG anti-A (B) titer in 480 pregnant women with O-type blood during pregnancy was carried out by microcolumn gel method. The distribution and changes of antibody titer of IgG anti-A (B) Occurrence rate. Results: Among the 480 pregnant women with O-type blood test, the titer of IgG anti-A (B) in the first trimester was 429 in <1:64 and 51 in 1:64 in IgG anti-A (B) Was 10.6%. In the second trimester, there were 369 cases of IgG anti-A (B) titer <1:64, 111 cases of IgG anti-A (B) titer ≥1:64 and the abnormality rate was 23.1% (B) There were 311 cases with titer <1:64. The titer of IgG anti-A (B) ≥1:64 was 169 cases, the incidence of abnormality was 35.2%, with significant difference (P <0.05). Sixty-two HDN-bearing children with a HDN of 36.7% had IgG-A (B) titers ≥1: 64 in 169 pregnant women with a titer of <1: 64 in 311 other IgG anti-A There were 28 cases of HDN and the incidence of HDN was 9.0%. There was significant difference between the two groups (P <0.05). There was no significant difference between O / A and O / B. CONCLUSIONS: The prevalence of HDN increases with the level of IgG anti-A (B) antibody in the mother’s body. It is necessary to dynamically monitor the serum IgG anti-A (B) titer of pregnant women with O-type blood during pregnancy. ABO hemolysis Disease occurs, early prevention.
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