目的：探讨血型不合孕妇产前免疫性抗体检测对产后新生儿溶血病（HDN）诊断的价值。方法：采用常规血型血清学方法对386名 ABO 血型不合的孕妇进行产前 IgG 抗 A 或抗 B 效价测定及8名 RhD 阴性孕妇进行抗-D 检测，并对 IgG 抗体进行亚型分型检测，分析产后 HDN 的发生与产前免疫性抗体检测的关系。结果：386例 ABO 血型不合的孕妇产前 IgG 抗 A 或抗 B 效价分布与血型分布无相关性（P ＞0．05）。 IgG 抗 A 或抗 B 效价≥64与产后发生ABO-HDN 呈正相关性，随着抗体效价的升高呈上升趋势（P ＜0．05），抗体效价≥1024时几乎不可避免地发生HDN ；在对母亲及患儿血型 IgG 抗 A 或抗 B 抗体类型检测中发现 IgG1和 IgG2型；RhD 阴性孕妇产生抗-D 的频率为62．5％，产前抗-D 效价持续升高可造成胎儿发育不良以至终止妊娠。结论：产前 IgG 抗 A 或抗 B 抗体效价水平越高越有可能发生 HDN ，效价高于1024发生 HDN 的几率极高，产前抗-D 效价持续升高将严重影响胎儿发育，与夫妇血型不合类型无关，且主要以 IgG1和 IgG2型抗体为主。%Objective :To explore the diagnostic value of detection immune antibody in pregnant women with blood group incompatibility for preventing hemolytic disease of the newborn (HDN) .Methods :386 pregnant women with ABO blood group incompatibility and 8 RhD negative pregnant women were determinated IgG anti-A or anti-B or anti-D with conventional serology methods ,to analysis IgG antibody subtype classification and the relationship between postpartum HDN occurs and prenatal immune a11tibodies .Results :It’s no correlation of ABO blood type with pregnant women pre-natal IgG anti-A ,or anti-B titer distribution in 386 cases (P > 0 .05) ,IgG anti-A ,or anti-B titer ≥ 64 and postpartum occurred ABO-HDN have correlation ,with the antibody titer rising ,the occurred rate is rising (P< 0 .05) ,antibody titer≥ 1 024 are almost inevilable to occurred HDN ;blood type IgG anti-A ,or anti-B antibody type detection in the found IgG1 and IgG2 type ;frequency of RhD-negative pregnant women anti-D to 62 .5% ,if anti-D titer continued to rise ,it can cause prenatal fetal development as well as the termination of pregnancy .Conclusion :The higher of leve IgG anti-A or anti-B antibodies titer in prenatal woman ,the more likely HDN ,the titer higher than 1 024 HDN occurs extremely high risk ,anti-D titer continued to rise will seriously affect fetal development ,it is no correlatinn with couples blood group incompatibilily type ,IgG antibody subtype classification were dominated by IgG 1 and IgG2 antibodies .
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