ABO新生儿溶血与O型血产妇产前抗体效价关系研究

doi:10.12183/j.scjpm.2023.0696

摘要/Abstract

摘要： 目的观察ABO新生儿溶血病发病情况并分析其与产妇产前抗体效价关系。方法将2021年1月至2022年12月海口市妇幼保健院和儋州市妇幼保健院产检并生育的夫妇血型不合的O型血孕妇作为研究对象,采用抗人球蛋白微柱凝胶法测定抗体效价,并对其产后ABO新生儿溶血病情况进行检测和统计,分析ABO新生儿溶血与O型血产妇产前抗体效价关系。结果获得有效研究对象1 006例,有效率91.70%。夫妇血型O-A型398例、O-B型371例、O-AB型237例,分别占比39.56%、36.88%、23.56%。孕妇IgG抗体效价≤1∶32、1∶64、1∶128、1∶256、1∶512、>1∶512者分别占17.20%、22.56%、20.38%、22.37%、10.04%、7.46%。共检出ABO新生儿溶血病251例,阳性率24.95%。夫妇血型O-A型、O-B型、O-AB型的ABO新生儿溶血病阳性率分别为22.36%、24.26%、30.38%,组间差异无统计学意义（P>0.05）。孕妇IgG抗体效价≤1∶32、1∶64、1∶128、1∶256、1∶512、>1∶512者产后ABO新生儿溶血病检出率分别为0.00%、11.45%、32.68%、38.67%、39.60%、41.33%,组间差异有统计学意义（P<0.05）。多因素logistic回归分析显示孕妇中IgG抗体效价（OR=2.415,95% CI：1.329~5.974）是ABO新生儿溶血病的相关影响因素。结论 ABO新生儿溶血与O型血产妇产前抗体效价密切相关,随着抗体效价增高、ABO新生儿溶血患病率增加,产前对孕妇进行血型IgG抗体效价检测对ABO新生儿溶血的防治具有重要意义。

关键词: ABO新生儿溶血病, O型血, 产妇, 产前, 抗体效价

Abstract: Objective To study the incidence of ABO hemolytic disease of newborn and analyze the relationship between ABO hemolytic disease of newborn and prenatal antibody titer of maternal. Methods From January 2021 to December 2022, women with O blood group who were incompatible with their husband and gave birth in Haikou Maternal and Child Health Hospital and Danzhou Maternal and Child Health Hospital were selected for this study. The antibody titer was determined by anti-human globulin microcolumn gel method. ?After delivery, ABO hemolytic disease of newborn was detected and analyzed, and the relationship between ABO hemolytic disease of newborn and prenatal antibody titer of O blood maternal was analyzed. Results A total of 1 006 effective subjects were obtained, with an effective rate of 91.70%. There were 398 cases of O-A type, 371 cases of O-B type, and 237 cases of O-AB type in couples, accounting for 39.56%, 36.88%, and 23.56%, respectively. The distribution of IgG antibody titer in serum of pregnant women ≤1∶32, 1∶64, 1∶128, 1∶256, 1∶512, and>1∶512 accounted for 17.20%, 22.56%, 20.38%, 22.37%, 10.04%, and 7.46%, respectively. There were 251 cases of ABO hemolytic disease of newborn were detected, with a positive rate of 24.95%. The positive rates of ABO hemolytic disease of newborn of couple blood type O-A, O-B, and O-AB were 22.36%, 24.26% and 30.38%, respectively, and there was no significant difference between groups （P>0.05）. The detection rate of ABO hemolytic disease of newborn with IgG antibody titer distribution ≤1∶32, 1∶64, 1∶128, 1∶256, 1∶512, and >1∶512 in maternal serum were 0.00%, 11.45%, 32.68%, 38.67%, 39.60% and 41.33%, respectively, and the difference between the groups was statistically significant （P<0.05）. Multivariate Logistic regression analysis showed that IgG antibody titer （OR=2.415, 95% CI：1.329-5.974） of pregnant women was a related factor of ABO hemolytic disease of newborn. Conclusions ABO hemolytic disease of newborn is closely related to the prenatal antibody titer of O blood maternal. With the increase of antibody titer, the prevalence of ABO hemolytic disease of newborn increases. The blood type IgG antibody titer of pregnant women suggested to detect before delivery, which is of great significance for the prevention and control of ABO hemolytic disease of newborn.

Key words: ABO hemolytic disease of newborn, Type O blood, Maternity, Prenatal, Antibody titer

中图分类号:

R722.18

王秀灵, 韩燕媚, 谭三阳, 黄河, 王方霞. ABO新生儿溶血与O型血产妇产前抗体效价关系研究[J]. 华南预防医学, 2023, 49(6): 696-700.

WANG Xiuling, HAN Yanmei, TAN Sanyang, HUANG He, WANG Fangxia. Relationship between ABO hemolytic disease of newborn and prenatal antibody titer of O blood maternal[J]. South China Journal of Preventive Medicine, 2023, 49(6): 696-700.

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