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目的探讨O型孕妇妊娠期血清Ig G抗体效价对产后新生儿ABO溶血病(HDN)的发病影响。方法采用血型血清学方法,对771例血型不合的O型孕妇作Ig G抗体效价检测,并对其中妊娠次数>2次的516例孕妇作Ig G抗体水平比较,采用ELISA法对93例HDN患儿及其母亲、69例健康新生儿和81例健康O型孕妇的Ig G亚类作定量分析。结果 771例孕妇ABO Ig G抗-A(B)效价≥64者占72.9%(562/771),其中O-B组51.1%(287/562),OA组32.0%(180/562),O-AB组6.9%(95/562);771例新生儿中发生ABO HDN 93例(18.7%),ABO Ig G抗-A(B)效价≥128时,HDN的发病率达44.7%以上;妊娠次数>2次者,其Ig G抗-A(B)阳性率大于第2次妊娠者,差异有统计学意义(P<0.01);患儿及其母亲体内Ig G抗体的含量显著高于正常对照组,且以Ig G1为主。结论孕妇血清免疫性抗体、效价及其亚类的检测对预防HDN的发生具有重要意义,多次妊娠是发生HDN的高危因素。
Objective To investigate the influence of serum Ig G antibody titer during pregnancy on the incidence of postpartum neonatal ABO hemolytic disease (HDN). Methods Blood serum serology was used to detect IgG antibody titer in 771 pregnant women with O-type incompatible blood type. IgG antibody levels were measured in 516 pregnant women with more than 2 pregnancies. Serum levels of 93 HDN IgG subclasses of children and their mothers, 69 healthy newborns, and 81 healthy O-pregnant women were quantitatively analyzed. Results A total of 771 pregnant women with ABO Ig G anti-A (B) titer ≥64 accounted for 72.9% (562/771), including 51.1% (287/562) in OB group, 32.0% (180/562) in OA group, The incidence of HDN was more than 44.7% in ABN group, 6.9% (95/562) in AB group, 93 (18.7%) cases of ABO HDN in 771 newborns and ≥128 in ABO Ig G anti-A (B) The positive rate of Ig G anti-A (B) was significantly higher than that of the second pregnancy (P <0.01). The Ig G antibody levels in children and their mothers were significantly higher than those in normal Control group, and mainly Ig G1. Conclusion The detection of serum autoantibodies, titers and subclasses in pregnant women is of great importance in the prevention of HDN. Multiple pregnancies are the risk factors of HDN.