ABO新生儿溶血病与O型孕妇血清中IgG及其亚类含量的相关分析

目的探讨O型孕妇血清IgG抗体及其亚型含量与新生儿溶血病(HDN)的关系。方法采用血型血清学方法,对317名夫妇血型不合的O型孕妇作IgG抗体效价检测,并对其中有妊娠史的287名孕妇作IgG抗体水平比较;采用ELISA法对71名HDN患儿及其母亲、65名健康O型孕妇和51名健康新生儿的IgG亚类作定量分析。结果1)317名新生儿中发生ABOHDN71例(22.4%),其中抗-A46例、抗-B25例;2)随着妊娠次数的增加,IgG抗体效价≥64者的比例和ABO-HDN发病率升高,>2次妊娠与第2次妊娠间有统计学差异;3)患儿及其母亲体内IgG抗体的含量显著高于正常对照组,且以IgG1抗体为主,患儿体内的IgG1比例(61.9%)高于母体(52.8%)。结论新生儿ABOHDN的发病率随其母亲体内IgG抗体效价的升高而升高,且与母亲体内IgG1呈正相关。夫妇血型不合的O型孕妇应定期检测IgG抗体及其亚类含量。

The relationship between the IgG anti-body titers,the concentration of IgG subclasses of group O pregnant women and ABO hemolytic disease of newborn

Objective To study the relationship between the IgG antibody titer, the concentration of IgG subclasses in group O maternal sera and hemolytic disease of newborn. Methods By means of blood group serology assay, IgG antibody titers in 317 pregnant women who had incompatible blood group with their husbands was measured. The concentration of IgG subclasses were measured in HDN infants and their mothers, healthy pregnant women and healthy infants by ELISA. Results 1) Among 317 maternal sera, 153 cases (48.3%) were found to have IgG antibody titers higher than 1∶64, with anti-A and anti-B in 89 and 64 cases, respectively. Seventy-one (22.4%) newborns suffered from ABO-HDN, with 46 anti-A and 25 anti-B; 2) With increased numbers of pregnancy, the proportions women with greater than 1∶64 IgG antibody increased, and there was significant difference between those with one pregnancy and those with more than one pregnancies; 3) The levels of IgG antibody in HDN infants and their mothers were higher than those in control group, and IgG1 was the predominant subclass. Meanwhile, the proportion of IgG1 in infants was higher than in pregnant women. Conclusion To some couples of ABO incompatibility, IgG antibody titer and IgG subclasses should be tested in pregnant women. The incidence of HDN increases with increased antibody titers. The severity of HDN correlates positively with the concentration of IgG1 in maternal sera.