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目的探讨O型孕妇血清中IgG抗A(B)效价与新生儿溶血病的关系。方法应用微柱凝胶法检测504对夫妇血型不合的O型RH(D)阳性孕妇IgG抗A(B)效价,在分娩时采集新生儿脐带血测定ABO、RhD血型、直接抗人球蛋白试验、游离抗体试验和放散试验。结果 504名O型孕妇血清中,IgG抗A(B)效价≤1∶64有265例,1∶128有116例,1∶256有53例,1∶512有41例,1∶1024有29例。其中74名新生儿HDN阳性,经ROC曲线分析,血型抗体最佳临界值为1∶128,此点灵敏度93.2%,特异性66.1%,ROC曲线下面积0.872。结论用微柱凝胶法检测IgG抗A(B)效价,最佳临界值建议为1∶128,对新生儿溶血病的预测价值较高。
Objective To investigate the relationship between serum IgG anti-A (B) titer and neonatal hemolytic disease in type-O pregnant women. Methods The microcolumn gel method was used to detect the IgG anti-A (B) titer in 504 cases of O-type RH (D) positive pregnant women with abnormal blood type. Cord blood samples of neonates were collected for ABO, RhD blood type, direct anti-human globulin Test, free antibody test and discharge test. Results In 504 serums of type O pregnant women, there were 265 cases of IgG anti-A (B) titer ≤1: 64, 116 cases of 1:128, 53 cases of 1:256, 41 cases of 1:12 and 1:1024 29 cases. Among them, 74 neonates were positive for HDN. According to ROC curve analysis, the best cutoff value of blood group antibody was 1:128, the sensitivity of this point was 93.2%, the specificity was 66.1% and the area under ROC curve was 0.872. Conclusion The titer of IgG anti-A (B) was detected by microcolumn gel method. The optimal cut-off value was 1:128, which had a higher predictive value for hemolytic disease in neonates.