母儿ABO血型不合孕妇血清IgG抗体效价与新生儿溶血的相关性分析

目的探讨母亲孕期血型血清学的IgG抗体效价与新生儿ABO溶血病(HDN)的关系。方法选取2005年1月～2009年12月在我院分娩的2168例ABO血型不合孕妇及其新生儿为研究对象。以分娩前孕妇最后一次IgG抗A(B)效价值为标准,效价≥1∶64者列为研究范围。新生儿HDN则观察溶血3项筛查指标及其红细胞、血红蛋白、网织红细胞等。结果 2168例ABO血型不合孕妇中血清IgG抗体效价1∶64有710例,1∶128有800例,1∶256有519例,效价≥1∶512有171例。HDN发病患儿共529例。2次及以上妊娠孕妇的抗A、抗B抗体效价值大于1次妊娠者,差异有显著性,P<0.05;年龄30-40岁组孕妇的抗A和抗B抗体效价高于21-29岁组,差异有显著性,P<0.05;母亲IgG抗A或抗B抗体效价与新生儿ABO溶血的发生率相关,r=0.8119,P<0.05。结论孕妇血清中血型免疫性抗体IgG是引起HDN的主要原因,且随着IgG抗体效价的增高,HDN的发病率也增高,但不是HDN发病的唯一因素,妊娠次数的增多、年龄增大、不良生育史等因素可加重IgG抗体效价对HDN的发生。

Correlation analysis of the relationship between the efficiency of the serum IgG antibody by the maternal-fetal blood group incompatibility and ABO haemolytic disease of the newborn.

Objective： To study the relationship between the efficiency of the IgG antibody by the maternal-fetal blood group incompatibility and ABO haemolytic disease of the newborn（HDN）.Methods：Choosed 2168 gestational women with the the maternal-fetal blood group incompatibility and their newborns.The women were examined the IgG antibody to AbA and AbB of red blood cell in the maternal serum.The efficiency≥1∶64 was（＋）.The newborn diagnosed to be ABO haemolytic disease were examined their red blood cell,Hb,net blood cell.Results：A total of 2168 patients with the the maternal-fetal blood group incompatibility were involved in present study,including 710 cases of 1∶64,800 cases of 1∶128,519 cases of 1∶256 and 171 cases of 1∶512.The rate of（＋） for the AbA,AbB of the gestational women with more than one time pregnancy was higher than those with only one pregnancy.The difference was significant,P0.05;the elder was higher than the younger,difference was significant,P0.05;Comparing with the newborn with the O blood group and others with the A or B blood group,the IgG antibody＇s efficiency of their mother was supplied differently,the difference was significant,P0.05.The haemolytic disease of the newborn will increase when the AbA and AbB IgG antibody＇s efficiency increase.r=0.8119,P0.05.Conclusions：The efficiency of the IgG antibody by the maternal-fetal blood group incompatibility was the main cause inducing HDN,but not the only cause,we should conside the pregnant women who have many times of pregnancy,who are elder or have unnomal pregnancy before.