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目的探讨孕妇IgG抗体效价与新生儿ABO血型不合溶血病(ABO-HDN)的关系。方法选择2010年1月至2013年1月在荆门市第二人民医院及荆门市妇幼保健院产检至孕16周后、与配偶血型不合的O型血孕妇,采用微柱凝胶法抗人球蛋白试验测定孕妇IgG抗体效价,孕16~20周进行首次血型抗体检查,对抗体效价≥64的孕妇每4周测定一次,观察IgG抗体效价对新生儿发生ABO-HDN的影响。结果纳入研究的1458例夫妻中,夫妻血型A-O组652例(44.7%),B-O组620例(42.5%),AB-O组186例(12.8%),其中母婴血型O-A者573例,O-B者435例。孕妇首次抗体效价≥64者1368例,异常检测率93.8%。对抗体效价≥64的孕妇动态监测抗体效价,64、128、256和≥512各组HDN发生率分别为0、11.8%、22.9%和42.2%,不同抗体效价组间发生率差异有统计学意义(χ2=76.545,P<0.001),共发生ABO-HDN 249例(17.1%,249/1458)。结论新生儿ABO-HDN的发生率随孕妇血型IgG抗体效价增高而升高,产前IgG抗体效价监测有助于筛选新生儿ABO-HDN高危人群。
Objective To investigate the relationship between IgG titer of pregnant women and ABO-HDN in neonates. Methods From January 2010 to January 2013 in Jingmen Second People’s Hospital and Jingmen City Maternal and Child Health Hospital, 16 weeks after pregnancy, O-type pregnant women with blood group incompatibility, the use of micro-column gel anti-human ball Protein test for the determination of pregnant women IgG antibody titers, the first 16 to 20 weeks pregnant for the first blood group antibody test, the antibody titers ≥ 64 pregnant women measured every 4 weeks to observe the impact of IgG antibody titers on neonatal ABO-HDN. Results Of the 1458 couples studied, 652 (44.7%) were in the AO group, 620 (42.5%) in the BO group, 186 (12.8%) in the AB-O group, 573 in the maternal-blood group OA 435 cases. Pregnant women for the first time antibody titer ≥ 64 were 1368 cases, the abnormal detection rate of 93.8%. Antibody titers were dynamically monitored in pregnant women with antibody titers ≥64, HDN incidence rates were 0, 11.8%, 22.9% and 42.2% in 64,128,256 and ≥512 groups, respectively, and the differences in the incidence rates of different antibody titers were There were 249 ABO-HDN cases (17.1%, 249/1458) in the statistical significance (χ2 = 76.545, P <0.001). Conclusions The incidence of neonatal ABO-HDN increases with the increase of blood group IgG antibody titer in pregnant women. Prenatal monitoring of IgG antibody titer is helpful for the screening of high-risk ABO-HDN neonates.