孕妇IgG抗体效价与新生儿溶血病发病的相关研究
|
摘要
目的研究"O"型血孕妇血清Ig G抗体效价与新生儿溶血病发病(hemolytic disease of newborn,HDN)之间的相关性。方法收集2014年6月-2016年6月本院产检并正常分娩的"O"型血孕妇,且夫妻之间的ABO血型均不合,动态监测该孕妇20周、24周、28周、32周及36周及产前的血清Ig G抗体,记录其分娩后新生儿溶血病的发生率。结果不同夫妇血型组合中各抗体效价例数百分比差异无统计学意义(P>0.05);多次妊娠孕妇血清Ig G抗-A(B)抗体效价高于初次妊娠孕妇,多次妊娠孕妇正常分娩后新生儿HDN的发生率明显高于初次妊娠孕妇,上述差异均有统计学意义(P<0.05)。结论产前对夫妇ABO血型不合的"O"型血孕妇行血清Ig G抗体效价的检测有利于HDN的防治,在不同孕周动态检测孕妇血清Ig G抗体效价对HDN的发病预测有重要价值。
Objective To study the relationship between serum IgG antibody titer of O type blood maternal and the incidence of hemolytic disease of newborn. Methods Pregnant women with type O blood for check and normal delivery were collected in this study during June 2014-June 2016,in which the ABO blood group was of incompatibility between husband and wife. We monitored the serum Ig G antibodies of pregnant women at 20 w,24 w,28 w,32 w,36 w and prenatal dynamically,and recorded the incidence of hemolytic disease in the newborn after delivery. Results There was no statistical significance in the difference of antibody titer among different blood type group couples( P > 0. 05). The serum Ig G anti-A( B) antibody titer of pregnant women with multiple pregnancy was higher than that of first pregnant women,and multiple pregnant women had neonatal HDN incidence after normal delivery was significantly higher than first pregnant women,and the above differences were statistically significant( P < 0. 05). Conclusion Detecting serum Ig G antibody titers of type O blood pregnant women in couple ABO-incompatible in prenatal is conducive to the prevention and treatment of HDN,and dynamic detection of pregnant women serum Ig G antibody titers in different gestational weeks has important value for the prediction of the incidence of HDN.
Objective To study the relationship between serum IgG antibody titer of O type blood maternal and the incidence of hemolytic disease of newborn. Methods Pregnant women with type O blood for check and normal delivery were collected in this study during June 2014-June 2016,in which the ABO blood group was of incompatibility between husband and wife. We monitored the serum Ig G antibodies of pregnant women at 20 w,24 w,28 w,32 w,36 w and prenatal dynamically,and recorded the incidence of hemolytic disease in the newborn after delivery. Results There was no statistical significance in the difference of antibody titer among different blood type group couples( P > 0. 05). The serum Ig G anti-A( B) antibody titer of pregnant women with multiple pregnancy was higher than that of first pregnant women,and multiple pregnant women had neonatal HDN incidence after normal delivery was significantly higher than first pregnant women,and the above differences were statistically significant( P < 0. 05). Conclusion Detecting serum Ig G antibody titers of type O blood pregnant women in couple ABO-incompatible in prenatal is conducive to the prevention and treatment of HDN,and dynamic detection of pregnant women serum Ig G antibody titers in different gestational weeks has important value for the prediction of the incidence of HDN.
引文
[1]Sainio S,Nupponen I,Kuosmanen M,et al.Diagnosis and treatment of severe hemolytic disease of the fetus and newborn:a 10-year nationwide retrospective study[J].Acta Obstet Gynecol Scand,2015,94(4):383-390.
[2]刘耀煌,周金安,方志军,等.新生儿黄疸与新生儿溶血病关系分析[J].临床血液学杂志:输血与检验,2015,28(2):298-299.
[3]Lin ZX,Dong QS.Detection and analysis of ABO Hemolytic disease in newborn[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2014,22(5):1432-1434.
[4]李东晖,黄捷丽,高玉洁,等.母婴ABO血型不合孕妇Ig G抗体效价与新生儿溶血病之间的关系探讨[J].华南国防医学杂志,2014,28(6):549-551.
[5]刘妍,刘昕鸣,阮峥,等.O型血孕妇产前Ig G抗体效价异常与新生儿溶血病发病关系的探讨[J].中国实用医药,2015,10(9):106-107.
[6]宋小川,李玉娇,许洁,等.O型血孕妇产前检测Ig G抗体效价与新生儿溶血病相关性分析[J].临床血液学杂志(输血与检验),2015,28(2):333-335.
[7]Cohen DN,Johnson MS,Liang WH,et al.Clinically significant hemolytic disease of the newborn secondary to passive transfer of anti-D from maternal Rh IG[J].Transfusion,2014,54(11):2863-2866.
[8]徐新,刘琦,王霞.新生儿ABO溶血病与ABO血型的关系[J].现代医药卫生,2016,32(16):2484-2486.
[9]叶海辉,李智山,皮佑珺,等.对孕妇早期检测及治疗在新生儿溶血症临床应用探讨[J].临床血液学杂志(输血与检验),2016,29(1):139-141.
[10]Kumar R,Saini N,Kaur P,et al.Severe ABO Hemolytic Disease of Newborn with High Maternal Antibody Titres in a Direct Antiglobulin Test Negative Neonate[J].Indian J Pediatr,2016,83(7):740-741.
[11]Louis D,More K,Oberoi S,et al.Intravenous immunoglobulin in isoimmune haemolytic disease of newborn:an updated systematic review and meta-analysis[J].Arch Dis Child Fetal Neonatal Ed,2014,99(4):F325-F331.
[12]Velkova E.Correlation between the Amount of Anti-D Antibodies and Ig G Subclasses with Severity of Haemolytic Disease of Foetus and Newborn[J].Open Access Maced J Med Sci,2015,3(2):293-297.
[13]Jain A,Poddar U,Elhence P,et al.Cholestasis in a neonate with ABO haemolytic disease of newborn following transfusion of ABO group-specific red cells compatible with neonatal serum:inspissated bile syndrome[J].Blood Transfus,2014,12(4):621-623.
[14]王向红,苏学艳,赵志英,等.新生儿溶血病与孕妇产前血型抗体效价水平的相关性分析[J].临床合理用药杂志,2016,9(13):50-52.
[15]Li P,Pang LH,Liang HF,et al.Maternal Ig G Anti-A and Anti-B Titer Levels Screening in Predicting ABO Hemolytic Disease of the Newborn:A Meta-Analysis[J].Fetal Pediatr Pathol,2015,34(6):341-350.
[2]刘耀煌,周金安,方志军,等.新生儿黄疸与新生儿溶血病关系分析[J].临床血液学杂志:输血与检验,2015,28(2):298-299.
[3]Lin ZX,Dong QS.Detection and analysis of ABO Hemolytic disease in newborn[J].Zhongguo Shi Yan Xue Ye Xue Za Zhi,2014,22(5):1432-1434.
[4]李东晖,黄捷丽,高玉洁,等.母婴ABO血型不合孕妇Ig G抗体效价与新生儿溶血病之间的关系探讨[J].华南国防医学杂志,2014,28(6):549-551.
[5]刘妍,刘昕鸣,阮峥,等.O型血孕妇产前Ig G抗体效价异常与新生儿溶血病发病关系的探讨[J].中国实用医药,2015,10(9):106-107.
[6]宋小川,李玉娇,许洁,等.O型血孕妇产前检测Ig G抗体效价与新生儿溶血病相关性分析[J].临床血液学杂志(输血与检验),2015,28(2):333-335.
[7]Cohen DN,Johnson MS,Liang WH,et al.Clinically significant hemolytic disease of the newborn secondary to passive transfer of anti-D from maternal Rh IG[J].Transfusion,2014,54(11):2863-2866.
[8]徐新,刘琦,王霞.新生儿ABO溶血病与ABO血型的关系[J].现代医药卫生,2016,32(16):2484-2486.
[9]叶海辉,李智山,皮佑珺,等.对孕妇早期检测及治疗在新生儿溶血症临床应用探讨[J].临床血液学杂志(输血与检验),2016,29(1):139-141.
[10]Kumar R,Saini N,Kaur P,et al.Severe ABO Hemolytic Disease of Newborn with High Maternal Antibody Titres in a Direct Antiglobulin Test Negative Neonate[J].Indian J Pediatr,2016,83(7):740-741.
[11]Louis D,More K,Oberoi S,et al.Intravenous immunoglobulin in isoimmune haemolytic disease of newborn:an updated systematic review and meta-analysis[J].Arch Dis Child Fetal Neonatal Ed,2014,99(4):F325-F331.
[12]Velkova E.Correlation between the Amount of Anti-D Antibodies and Ig G Subclasses with Severity of Haemolytic Disease of Foetus and Newborn[J].Open Access Maced J Med Sci,2015,3(2):293-297.
[13]Jain A,Poddar U,Elhence P,et al.Cholestasis in a neonate with ABO haemolytic disease of newborn following transfusion of ABO group-specific red cells compatible with neonatal serum:inspissated bile syndrome[J].Blood Transfus,2014,12(4):621-623.
[14]王向红,苏学艳,赵志英,等.新生儿溶血病与孕妇产前血型抗体效价水平的相关性分析[J].临床合理用药杂志,2016,9(13):50-52.
[15]Li P,Pang LH,Liang HF,et al.Maternal Ig G Anti-A and Anti-B Titer Levels Screening in Predicting ABO Hemolytic Disease of the Newborn:A Meta-Analysis[J].Fetal Pediatr Pathol,2015,34(6):341-350.