IgG亚型与新生儿ABO溶血病的相关性

摘要

目的 探讨O型孕妇血清IgG抗体及其亚型含量与新生儿ABO溶血病的相关性.方法 采用微柱凝胶免疫检测法检测625例夫妇血型不合的O型孕妇血清IgG抗A(B)效价水平,对孕妇IgG抗A(B)效价与新生儿ABO溶血病的发病率作比较;采用ELISA法对81例新生儿溶血病(HDN)患儿及患儿母亲、79例健康O型孕妇和75例健康新生儿的IgG亚类进行定量分析.结果 当抗体效价≥64时,才使新生儿发生HDN;新生儿ABO溶血病发病率随IgG抗A(B)效价水平升高而呈上升趋势;母体及患儿血清中 IgG1、IgG3和IgG4 的含量高于相应的对照组(P＜0.01),患儿母亲IgG1、IgG3和IgG4 的含量与患儿比较差异无显著性(P>0.05),患儿及母体血清中均以IgG1为主,IgG1和IgG3的含量,尤其是IgG1的含量与ABO血型系统的新生儿溶血病发病密切相关.结论 新生儿ABO溶血病发病率随其母亲体内IgG抗体效价水平升高而升高;对夫妇血型不合的O型孕妇,应定期检测IgG抗A(B)效价水平及其亚类含量.%Objective To study the relationships between neonatal ABO hemolytic disease and the IgG antibody titer or the concentrations of IgG subclasses in group O maternal serum. Methods By means of microtubes gel test ( MGT ), IgG antibody- titer was measured in 625 pregnant women who had incompatible blood group with their husbands.Concentrations of IgG subclasses were measured in HDN infants and their mothers, healthy gravidae and infants by ELISA. Results Neonates with maternal IgG antibody- titer higher than 1:64 were vulnerable to ABO - HDN. The incidence of HDN rose with increase of IgG antibody- titer. The concentrations of IgG1, IgG3 and IgG4 in maternal and neonatal sera from HDN group were significantly higher than those from respective controls ( P ＜ 0. 01 ), while there was no significant difference between maternal and neonatal sera in HDN group ( P ＞ 0. 05 ). The maternal concentrations of IgG1 and IgG3, especially IgG1, were significantly correlated with neonate ABO hemolytic disease. Conclusion The incidence of HDN rises with increase of IgG antibody- titer. Regular monitor of maternal IgG antibody- titer and IgG subclasses is necessary in gravidae with ABO incompatibility.