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目的观察0型孕妇产前及孕期IgG抗-A(B)效价水平变化,分析其与ABO新生儿溶血病发生的相关性;同时通过对产下的新生儿进行跟踪调查,研究各项指标与ABO新生儿溶血病的关联。方法采用抗球蛋白检测卡初检夫妻血型不合的O型孕妇IgG抗-A(B)效价,并对其中初检效价≥64的孕妇跟踪其孕期血型抗体效价变化情况(初检约在25孕周左右,复检在初检后约1月1次效价检测直至生产),产下的新生儿取静脉血进行5项试验:ABO血型、Rh血型、直接抗球蛋白试验、游离试验、热放散试验。结果初检1 563份血清中IgG抗-A(B)效价≥64者846例,异常检出率为54.13%(846/1 563);其中A型丈夫效价≥64检出423例,异常检出率为51.84%(423/816);B型丈夫效价≥64检出319例,异常检出率为55.96%(319/570);AB型丈夫效价≥64检出104例,异常检出率为58.76%(104/177)。初检结果与HDN相关性分别为:效价≥64组为14.89%,≥128组为59.72%。末次效价与HDN生成相关性分别为:效价≥64组为30.80%,≥128组为67.02%。末/初效价比≤1∶1组、2∶1组、4∶1组、8∶1组分别为770、55、19、2例,实验室诊断HDN阳性分别为66、36、18、2例,有黄疸、贫血分别为48、32、18、2例。跟踪846例孕妇所产新生儿中,A型、B型、O型分别417、328、101例,确诊HDN 126例,其中A型、B型、O型分别为82、43、1例。结论丈夫A、B、AB血型间相对HDN发生率差异无统计学意义。末次效价比初检效价更能有效的反应HDN的生成。末/初效价比值越大产生HDN的几率就越大,且临床症状出现黄疸、贫血就越重。确诊HDN 126例中新生儿性别分布差异无统计学意义。A、B、O血型分布差异有统计学意义,A型明显多于其他2种血型。
Objective To observe the changes of IgG anti-A (B) titer in prenatal and perinatal pregnancy of type 0 pregnant women and to analyze their correlation with hemolytic disease of neonates with ABO. At the same time, Associated with hemolytic disease of neonates with ABO. Methods Anti-globulin was used to detect the IgG anti-A (B) titer of the uncorrected O-type pregnant women in the first card examination. The pregnant women whose initial test titer was ≥64 were followed up for changes of blood group antibody titers during the first trimester In 25 weeks of pregnancy, the retest after about 1 month after the initial examination of the detection of a titer until production), neonatal neonates to take venous blood for 5 tests: ABO blood type, Rh blood type, direct antiglobulin test, free Test, heat dissipation test. Results A total of 846 patients with IgG anti-A (B) titer of ≥64 were detected in 5663 sera. The detection rate of anomaly was 54.13% (846/1 563). Among them, 423 patients with type A husband titer ≥ 64, The detection rate of anomaly was 51.84% (423/816); the detection rate of B type husband was 64 (31 cases), the rate of anomaly detection was 55.96% (319/570) The detection rate of anomaly was 58.76% (104/177). The results of the first examination and HDN were: titers≥64 group was 14.89%, ≥128 group was 59.72%. The correlation between the final titer and the HDN production was as follows: the titers ≥64 were 30.80%, ≥128 were 67.02%. Final / initial titer of ≤1:1 group, 2:1 group, 4:1 group and 8:1 group were 770, 55, 19 and 2 respectively. The positive rates of laboratory diagnosis of HDN were 66, 36, 18, 2 cases, jaundice, anemia were 48,32,18,2 cases. Among 846 neonates born in pregnant women, there were 417,328 and 101 cases of type A, B and O, and 126 cases of HDN were confirmed. Among them, type A, type B and type O were 82 and 43 respectively. Conclusion There was no significant difference in the relative HDN incidence between husbands A, B and AB. The last titer is more effective than the initial titer response HDN generation. The higher the ratio of the final / initial titer is, the greater the chance of producing HDN, and the clinical symptoms of jaundice, the heavier the anemia. No significant difference was found in the gender distribution of neonates diagnosed in 126 cases of HDN. A, B, O blood type distribution was statistically significant, type A was significantly more than the other two blood groups.