ABO新生儿溶血病与孕妇血型抗体效价的关系

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目的探讨孕妇血型抗体效价与新生儿溶血病的关系。方法628例孕妇常规进行ABO血型鉴定、Rh血型鉴定、不规则抗体筛查,对筛查阳性者进行抗体特异性鉴定,对有临床意义的抗体采用微柱凝胶法测定其效价。结果628对夫妇中ABO血型相合264对(42.0%),不相合364对(58.0%),其中IgG抗A(B)效价≥64的O型孕妇286例,B型孕妇1例。Rh血型相合626例(99.68%),不相合2例(0.32%),其中1例IgG抗D效价为256、合并IgG抗A效价为128,1例IgG抗E效价为32。O型孕妇血清IgG抗体阳性率较高,且与其丈夫血型不同,AB型最高,B型次之,A型最低,差异有统计学意义(χ2=7.771,P=0.021)。O型孕妇血清IgG抗体阳性率明显高于其他血型孕妇血清IgG抗体阳性率,差异有统计学意义(χ2=91.081,P=0.000)。结论O型孕妇比其他型孕妇更易引起新生溶血病,特别是孕妇为O型和其丈夫AB型更易引起新生儿溶血病。 Objective To investigate the relationship between blood group antibody titers and hemolytic disease in newborn. Methods 628 pregnant women were routinely identified by ABO blood type, Rh blood type and irregular antibody screening. Antibody specificity was identified in patients with positive screening. The titer of the antibody was determined by microcolumn gel method. Results Among 628 couples, 264 pairs (42.0%) of the ABO blood group were unmatched with 364 pairs (58.0%). There were 286 type O pregnant women whose IgG anti-A (B) titer was ≥64 and 1 type B pregnant women. There were 626 cases (99.68%) of Rh blood type incompatibility with 2 cases (0.32%), of which 1 case had IgG anti-D titer of 256, IgG anti-A titer was 128 and 1 case IgG anti-E titer was 32. The positive rate of serum IgG in O pregnant women was higher than that of their husbands. The highest positive rate of AB was found in type AB, the lowest in type B, and the lowest was in type A (χ2 = 7.771, P = 0.021). The positive rate of serum IgG in O pregnant women was significantly higher than that in other pregnant women (χ2 = 91.081, P = 0.000). Conclusion O-type pregnant women are more likely to cause hemolysis than other types of pregnant women, especially pregnant women O type and her husband AB type more likely to cause neonatal hemolytic disease.
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