微柱凝胶法检测ABO母婴血型不合孕妇血清抗-A（B）IgG效价1154例的结果分析

目的探讨微柱凝胶法（MGT）检测1 154例ABO母婴血型不合孕妇血清抗-A（B）IgG效价的临床意义。方法采用MGT法对1 154例ABO母婴血型不合孕妇进行产前血清抗-A（B）IgG效价测定,分析血清抗-A（B）IgG效价与新生儿溶血病（HDN）发生的相关性。结果 1 154例孕妇在孕20周首次血清抗-A（B）IgG效价测定≥1∶64者占72.36%（835/1 154）,其中O-A型、O-B型和O-AB型夫妇抗-A（B）IgG效价的阳性率分别为72.48%（366/505）、66.45%（313/471）和80.90%（144/178）,各组阳性率差异有统计学意义（χ2=13.765,P〈0.01）。在产前第30周左右对1 154孕妇中的340例进行抗-A（B）IgG效价的二次随机测定,发现50.50%（51/101）孕妇抗体效价从阴性转为阳性,51.80%（129/249）孕妇（效价≥1∶64）抗体效价继续上升,其中O-A型、O-B型和O-AB型夫妇抗-A（B）IgG效价上升率分别为53.74%（79/147）、50.00%（77/154）和56.41%（23/39）,各组间差异无统计学意义（χ2=1.130,P〉0.05）;25例发生HDN的患儿母亲产前抗-A（B）IgG效价测定均≥1∶256,其中有12例血型抗体效价持续升高达4倍以上,1例效价〈1∶64。结论 ABO母婴血型不合孕妇血清抗-A（B）IgG效价水平与HDN的发生显著相关,利用MGT检测孕妇血清抗-A（B）IgG效价有助于HDN的早期诊断和干预。

Analysis of results of serum anti-A(B) IgG titer detection in 1 154 cases maternal-fetal ABO blood group incompatible pregnant women by microcolumn gel technology

Objective To investigate the clinical significance of detection the titer of serum anti-A(B) IgG in 1 154 ABO blood group incompatible pregnant women by microcolumn gel technology(MGT).Methods Detect the titer of serum anti-A(B) IgG in 1 154 cases ABO incompatible pregnant women,and evaluate the relationship between the titer of serum anti-A(B) IgG and hemolytic disease of newborn(HDN).Results 72.36% of total 1 154 cases ABO incompatible pregnant women for the first time detection at 20 weeks′ pregnant have the titer of serum anti-A(B) IgG higher than 1∶64,in which the positive rate in O/A,O/B and O/AB type couple group account for 72.48%(366/505),66.45%(313/471) and 80.90%(144/178),respectively.There was statistically significant difference between the positive rate of each groups(χ2=13.765,P<0.01).The titer of serum anti-A(B) IgG in 340 cases pregnant women in 1 154 at about 30 weeks’ pregnant was randomly detected for the second time.It was found that the titer of serum anti-A(B) IgG in 50.50%(51/101) pregnant women was transformed from negative to positive,and the titer in 51.80%(129/249) pregnant women was increased continuously,in which the rate of rise of 3 groups of O/A,O/B and O/AB types were 53.74%(79/147),50.00%(77/154) and 56.41%(23/39),respectively.There was no statistically significant among 3 groups(χ2=1.130,P>0.05).In mothers of 25 cases newborns with HDN,the titer of serum anti-A(B) IgG of 25 cases who had newborn with HDN was higher than 1∶256 and of which the titer of that of 12 cases increased more than 4 times.Only one case,the titer was less than 1∶64.Conclusion There was a significant relationship between the titer of serum anti-A(B) IgG in ABO blood group incompatible pregnant women and HDN.