孕期IgG血型抗体与ABO新生儿溶血病相关系数研究

目的:检测江淮地区汉族丈夫血型为A型、B型、AB型的O型孕妇孕期lgG血型抗体效价,并探讨其与ABO新生儿溶血病(ABOHDN)的相关系数,寻找最佳检测时机与治疗方案。方法:1991年11月～2004年10月检查1553对夫妇,检测孕妇lgG抗A(B)抗体效价,效价超过1:64以上者经中药治疗后复查其血型抗体效价。跟踪研究孕期血型抗体效价变化与活产儿ABOHDN的相关性。结果:ABOHDN的溶血程度与高效价IgG抗A(B)抗体并不呈正相关,但ABOHDN的发生与孕期动态升高的IgG血型抗体末次效价与初次效价的比值呈正相关,相关系数r为0.88803;丈夫为A型、B型、AB型的O型孕妇母婴血型不合发生率为55.89%;IgG抗A(B)抗体效价≥1∶64的发生率为45.87%,ABOHDN的发生率为38.57%;ABOHDN患儿中,母婴血型O-A∶O-B为1.099∶1,无显著性差异。结论:孕期基础血型抗体效价高者不一定发生新生儿溶血病;动态检测IgG血型抗体,孕前、孕中、临产前、新生儿脐血或静脉血检测,持续不降甚至升高者最易发生新生儿溶血病。

Research on correlation coefficient between IgG antibody during gestation and ABO hemolytic disease of the newborn

Objective:To detect the IgG antibody concentration of the pregnant women, whose husbands' blood types are A,B or AB in the area of Jianghuai,and to discuss the correlation coefficient between IgG concentration and ABO hemolytic disease of newborn (ABOHDN), then to seek the best detection period and treatment scheme.Methods:From Nov.1991 to Oct.2004, 1 553 couples were tested.First, the IgG concentrations of the pregnant women were detected.The pregnant women with titre higher than 1∶64 were treated by Chinese drugs to redetect the correlation coefficient mentioned above. Results:The morbility of ABOHDN had a positive relationship with IgG concentration which was rising during gestation.The correlation coefficient was 0.888 03, O-A∶O-B was 1.099∶1, and there was no significant difference.Conclusion:A high IgG concentration does not definitely cause HDN.The index before and during gestation should be detected, invovling the newborns.One with high level or at a rising concentration of IgG is apt to get HDN.