IgG亚型与新生儿ABO溶血病相关性的研究

摘要] 目的：探讨O型孕妇血清IgG抗体及其亚型含量与新生儿ABO溶血病的相关性。方法：采用微柱凝胶免疫检测法，检测625名夫妇血型不合O型孕妇血清IgG抗A(B)效价水平，对孕妇IgG抗A(B)效价与新生儿ABO溶血病的发病率比较；采用ELISA法对81名HDN患儿及患儿母亲、79名健康O型孕妇和75名健康新生儿的IgG亚类进行定量分析。结果：当抗体效价≥64时，才使新生儿发生HDN；新生儿ABO溶血病发病率随IgG抗A(B)效价水平升高而呈上升趋势;母体及患儿血清中 IgG1、IgG3和IgG4 的含量高于相应的对照组(P﹤0.01)，患儿母亲G1、IgG3和IgG4 的含量与患儿无显著性(P﹥0.05)，患儿及母体血清中均以IgG1为主，IgGl和IgG3的含量，尤其是IgGl的含量与ABO血型系统的新生儿溶血病发病密切相关系。结论：新生儿ABO溶血病发病率随其母亲体内IgG抗体效价水平升高而升高；对夫妇血型不合O型孕妇，应定期检测IgG抗A(B)效价水平及其亚类含量。

Relationship between IgG subclasses and ABO hemolytic disease of newborn

Abstract Objective To Study the relationships between the IgG antibody titer,the concentration of IgG subclasses in group O maternal serum and ABO hemolytic disease of newborns . Methods By means of microtubes gel test (MGT), IgG antibody titer in 625 pregnant women who had incompatible blood group with their husbands was measured. The concentration of IgG subclasses were measured in HDN infants and their mothers,healthy pregnant women and healthy infants by ELISA. Results The mother who IgG antibody titer higher than 1:64,Their newborns suffered from ABO-HDN easlly. The incidence of HDN increases with increased IgG antibody titer. The concentration of IgG1、IgG3 and IgG4 in mothers and ill-infants’ serum were higher than that in controls(P﹤0.01)while there was no difference from infant’s (P﹥0.05). The concentration of IgG1、IgG3 in mother’s serum,especially IgG1 is important in pathogenesis of ABO hemolytic disease .Conclusion The incidence of HDN increases with increased IgG antibody titer.　To some couple of ABO incompatibiliy, IgG antibody titer and IgG subclasses should be tested in pregnant woman.