O型血多次妊娠孕妇lgG抗体效价与新生儿溶血病关系探讨

摘要

Objective To explore the relationship among pregnancy times of women with O blood type whose husbands have different blood types, the serum antibody titers of IgG of anti A( B ) and hemolytic disease of the newborn ( HDN ). Methods The blood types of pregnant women and their husbands were determined in 207 cases with their first pregnancies,45 cases with their second pregnancies and 67 cases with over 3 times pregnancies,while the serum antibody titers of IgG of anti A( B ) of these women were examined by microcolumn gel technique ( MGT ). The blood types of the newborns were determined when their mothers'antibody titers were ≥ 1: 64, and the blood type serology assay was made. Results Among 207 cases of women with their first pregnancies, 44 cases ( 21.3％ ) were found IgG antibody titers ≥ 1:64 ,while 163 cases ( 78.7％ ) IgG antibody titers ≤ 1:64. Among 112 cases of women with their multiple pregnancies, the antibody titers of IgG were ≥1:64 in 61 cases ( 54.5％ ), and lower than 64 in 51 cases ( 45.5％ ). Among 105 cases of women whose antibody titers were ≥ 1: 64, 6 out of 45 newborns suffered from HDN when the antibody titers of their mothers were 1: 64, corresponding to a morbidity of 13.3％; 11 out of 32 cases suffered from this disease when the antibody titers of mothers were 1: 128, coresponding to a morbidity of 34.4％; 17 out of 28 cases suffered from HDN when the antibody titers of mothers were ≥ 1:256, corresponding to a morbidity of 60.7％. Conclusion The level of the serum antibody titers of IgG of anti A ( B ) of the pregnant women correlate positively with the times of pregnancies. The higher the level of the serum antibody titers of IgG of anti A ( B ) before delivery, the higher the incidence of HDN after delivery. The level of IgG of anti A ( B ) of the pregnant women with O blood type should be examined in time, and these woman should be treated if abnormal was found.%目的 探讨血型不合夫妻中,O型血孕妇妊娠次数、血清中lgG抗A(B)效价与新生儿溶血病(HDN)的关系.方法 采用微柱凝胶技术对207例首次妊娠、45例2次妊娠和67例≥3次妊娠夫妇进行血型鉴定及孕妇血清中lgG抗A(B)效价测定.效价≥1∶64孕妇所生新生儿结合临床症状做血型鉴定及HDN免疫血清学检测.结果 207例首次妊娠孕妇血清中lgG抗A(B)效价≥1∶64者44例(21.3%),<1∶64者163例(78.7%);112例多次妊娠孕妇血清中lgG抗A(B)效价≥1∶64者61例(54.5%),<1∶64者51例(45.5%);效价≥1∶64的105例产妇中,lgG抗A(B)效价为1∶64的45例中发生HDN 6例(13.3%),lgG抗A(B)效价为1∶128的32例中HDN 11例(34.4%),lgG抗A(B)效价≥1∶256的28例中HDN 17例(60.7%).结论 lgG抗A(B)效价阳性率与妊娠次数呈正相关;产前lgG抗A(B)效价越高,HDN发病率就越高,O型血孕妇应定期检测体内lgG抗A(B)效价水平,结果异常及时治疗.