• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)

临床输血与检验 ›› 2020, Vol. 22 ›› Issue (3): 269-272.DOI: 10.3969/j.issn.1671-2587.2020.03.011

• 临床输血 • 上一篇    下一篇

母婴血型不合新生儿溶血病IgG抗体亚型分析*

马印图, 王更银, 李烛, 张怡, 杨晓亚, 李莉华   

  1. 050082 石家庄,解放军第九八〇医院输血科(马印图、王更银、李烛、张怡、杨晓亚);
    河北省血液中心质量法规处(李莉华)
  • 收稿日期:2018-12-02 出版日期:2020-06-20 发布日期:2020-06-13
  • 通讯作者: 李莉华,女,主任检验师,主要从事输血相关质量管理方面的工作,(Tel)15931096399(E-mail)13722793663@163.com。
  • 作者简介:马印图(1969-),男,回族,河北石家庄人,副主任技师,硕士,主要从事血液免疫学及母婴血型不合新生儿溶血病早期干预治疗方面的研究工作,(Tel)13722793663。
  • 基金资助:
    *本课题受河北省卫健委科研基金(No.20170956)资助

The Analysis of the Blood Type Antibody IgG Subsets in the Hemolytic Disease of the Newborn

MA Yin-tu, WANG Geng-yin, LI Zhu, et al   

  1. Department of Blood transfusion,Bethune International Peace Hospital of PLA 050082
  • Received:2018-12-02 Online:2020-06-20 Published:2020-06-13

摘要: 目的 探讨新生儿体内血型抗体IgG亚型的含量与其溶血危重程度的相关性。方法 对50例产前高效价的孕产妇进行产后新生儿免疫血液学检测(ABO 41例,Rh 9例),其中32例新生儿临床及实验室诊断为新生儿溶血病,采用微柱凝胶IgG亚型检测卡测定患儿及其母亲血清IgG抗体亚型,其中ABO血型系统25例,Rh系统7例。结果 在32例新生儿溶血病的患儿血清中检测出26例IgG1和IgG3亚型同步升高,21例IgG1和IgG2亚型升高;12例IgG3明显升高的产后新生儿均出现严重的高胆红素血症表现,而8例IgG2或IgG4亚型升高的孕妇,其新生儿均未发现高胆红素血症表现。结论 胎母间血型抗体亚型含量成正相关、IgG1和IgG3抗体亚型的含量与新生儿高胆红素血症的危重程度密切相关,对高效价孕妇有必要进行IgG亚型分析,对检出不同IgG亚型的孕妇进行选择性治疗,从而实现个体化精准干预治疗。

关键词: 孕妇, 血型抗体, 新生儿溶血病, IgG亚型, 微柱凝胶技术

Abstract: Objective To study the relationship between the blood type antibodies IgG subsets and the risk of newborns hyperbilirubinemia. Methods The serum of 50 cases high titer antibodies gravidaes and their newborns were carried out the serology detection(ABO 41 cases and Rh 9 cases).The IgG subsets and serum bilirubin levels of 32(ABO 25 cases and Rh 7 cases)in total 41cases newborns who diagnosed as hemolytic disease were tested by the method of microcolum gel technology. Results 26 in 32 cases newborns had positive IgG1 or IgG3 synchronously. The concentration of IgG1 or IgG2 in 21 cases newborns was synchronously raised. There were 12 cases the IgG3 positive newborns developed hyperbilirubinemia and their bilirubin levels were significantly higher than that of only IgG1 positive neonates. However, there were 8 pregnant women with higher IgG2 or IgG4, their neonates were not discovered the symptom of hyperbilirubinemia. Conclusions There were positive relative for the blood type antibodies IgG subsets among the gravidaes and their neonates,especially IgG1 and IgG3 were important in pathogenesis of heamolytic disease of neonates caused by blood type. The IgG subsets detection was necessary for the high titer antibodies gravidaes. It might be helpful to early diagnose hyperbilirubinemia of newborns. The method could be provided a directional significance in early intervention of blood group incompatible hemolytic disease of the newborns and carried out an individual precise intervention treatment.

Key words: Gravida, Blood type antibody, Hemolytic disease of the newborn(HDN), IgG subsets, Microcolum gel technology assay(MGTA)

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