ABO-HDN患儿血型IgG抗体效价及亚型的分布特征分析*

doi:10.3969/j.issn.1671-2587.2023.06.007

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (6): 753-757.DOI: 10.3969/j.issn.1671-2587.2023.06.007

ABO-HDN患儿血型IgG抗体效价及亚型的分布特征分析^*

陈源, 张晓丹, 叶若婷, 吴伟祥, 刘成义

广东省妇幼保健院,广东广州 511442

收稿日期:2023-09-08 出版日期:2023-12-20 发布日期:2024-01-15
通讯作者: 刘成义,主要从事临床输血与检验方面研究,（E-mail）liuchengyi_88@163.com。
作者简介:陈源,主要从事临床血液与检验方面研究,（E-mail）yuanchen919@gzhmu.edu.cn。
基金资助:
*本课题受广东省自然科学基金资助项目（No.2020A1515010434）资助

Analysis of the Distribution Characteristics of IgG Antibody Titers and Subtypes in ABO-HDN

CHEN Yuan, ZHANG Xiaodan, YE Ruoting, et al

Department of Clinical Laboratory, Guang Dong Women And Children Hospital, Guangzhou 511442

Received:2023-09-08 Online:2023-12-20 Published:2024-01-15

摘要/Abstract

摘要： 目的研究ABO新生儿溶血病（ABO-HDN）患儿IgG抗体效价及亚型的检测情况与分布特征,为临床诊治ABO-HDN提供实验室诊断依据。方法选择222例新生儿为研究对象,收集新生儿临床基本资料、溶血相关检测指标（总胆红素TBiL、间接胆红素IBiL、血红蛋白Hb）和蓝光治疗时长等数据资料,采用微柱凝胶法进行溶血三项试验、IgG抗体效价及亚型检测。分析IgG抗体效价与亚型的分布特点及其与患儿溶血严重程度的关系。结果新生儿溶血三项试验共检测出阳性142例,阴性80例,阳性组TBiL和IBiL水平高于阴性组, A型新生儿发病率高于B型新生儿,差异均具有统计学意义（P<0.05）。在新生儿血型IgG抗体效价检测中,游离抗体效价最高为16,放散抗体效价最高为32,随着患儿游离或放散抗体效价的升高,TBiL、IBiL含量及蓝光治疗时长呈升高趋势,Hb呈下降趋势。新生儿体内检测出IgG1和IgG1/G3亚型,IgG1和（或）IgG3抗体主要分布在高效价组（≥8）,与低效价组（<8）相比,各溶血指标比较均具有统计学差异（P<0.05）。结论高效价的IgG抗体及IgG1/G3亚型与溶血严重程度相关,检测新生儿血型IgG抗体效价及亚型有助于临床判断和防治ABO新生儿溶血病。

关键词: ABO新生儿溶血病, 溶血三项试验, IgG抗体效价, IgG抗体亚型

Abstract: Objective To study the detection and distribution characteristics of IgG antibody titers and subtypes in newborns with ABO hemolytic disease (ABO-HDN), and provide laboratory diagnostic evidence for clinical diagnosis and treatment of ABO-HDN. Methods 222 newborns were selected as research subjects. Clinical basic data of newborns, hemolysis related testing parameters (TBiL, IBiL, Hb), and data of blue-ray therapy were collected. Three hemolysis tests, IgG antibodies titer and subtype detection were performed using microcolumn gel method. The distribution characteristics of IgG antibody titer and subtype were analyzed, as well as their relationship with the severity of hemolysis in newborns. Results A total of 142 cases were positive and 80 cases were negative. The levels of TBiL and IBiL in the positive group were higher than those in the negative group, and the incidence rate of newborns with type A is higher than that of type B, the difference was statistically significant (P<0.05). In the detection of IgG antibody titers in newborns, the highest titer of free antibody was 16, and the highest titer of release antibody was 32. With the increase of the titer of free or release antibody in newborns, the level of TBiL, IBiL, and Blu-ray treatment duration tended to increase, while Hb levels tended to decrease. IgG1 and IgG1/G3 subtypes were detected in the newborns, and IgG1 and/or IgG3 antibodies were mainly distributed in the high titer group (≥8). Compared with the low titer group (<8), each hemolytic parameter showed statistically significant differences (P<0.05). Conclusion High titer IgG antibodies and IgG1/G3 subtypes are associated with the severity of hemolysis. It can provide important laboratory data support and helpful for clinical diagnosis, prevention and treatment of ABO-HDN.

Key words: ABO hemolytic disease of the newborn, Three hemolysis tests, IgG antibody titer, IgG antibody subtype

中图分类号:

R722.18

陈源, 张晓丹, 叶若婷, 吴伟祥, 刘成义. ABO-HDN患儿血型IgG抗体效价及亚型的分布特征分析^*[J]. 临床输血与检验, 2023, 25(6): 753-757.

CHEN Yuan, ZHANG Xiaodan, YE Ruoting, et al. Analysis of the Distribution Characteristics of IgG Antibody Titers and Subtypes in ABO-HDN[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(6): 753-757.

参考文献

[1] JACKSON M E,BAKER J M.Hemolytic disease of the fetus and newborn[J].Clin Lab Med,2021,41(1):133-151.
[2] JAIN A,MALHOTRA S,MARWAHA N,et al.Severe ABO hemolytic disease of fetus and newborn requiring blood exchange transfusion[J].Asian J Transfus Sci,2018,12(2):176.
[3] DELANEY M.Haemolytic disease of the fetus and newborn:advancements in precision and prevention[J].ISBT Sci Ser,2019,14(1):32-36.
[4] 宋建,杨婷,周小芳,等.新生儿体内IgG型血型抗体效价与新生儿溶血病严重程度的相关性分析[J].中国实验血液学杂志,2022,30(2):547-551.
[5] 马印图,陈莉,张怡,等.新生儿溶血3项试验与血型抗体Ig G亚型的相关性分析[J].医学研究杂志,2020,49(8):117-120.
[6] 陈卓瑶,邓秋连,黄映红,等.溶血三项检测血清总胆红素及IgG抗体效价与新生儿ABO溶血病的关系探讨[J].新疆医科大学学报,2020,43(8):1069-1072.
[7] 尹明伟,陈学军,曾智,等.母婴ABO血型不相合的高胆红素血症患儿新生儿溶血病确诊率的影响因素分析[J].国际检验医学杂志,2020,41(6):663-666.
[8] 吴淑华,苗锐.150例高胆红素血症新生儿溶血三项检测及相关影响因素分析[J].国际检验医学杂志,2019,40(9):1134-1137.
[9] KROG G R,DONNEBORG M L,HANSEN B M,et al.Prediction of ABO hemolytic disease of the newborn using pre-and perinatal quantification of maternal anti-A/anti-B IgG titer[J].Pediatr Res,2021,90(1):74-81.
[10] 杨雪,詹江辉,仲华,等.新生儿体内IgG型ABO血型系统抗体效价评估新生儿溶血病严重程度的临床价值[J].临床研究,2022,30(10):14-18.
[11] 王星,王晓卫,王雅茹,等.ABO新生儿溶血病患者就诊日龄与胆红素水平的相关性分析[J].临床血液学杂志,2022,35(10):717-719.
[12] 李克泉,刘美,薛见珍.综合治疗联合蓝光照射对新生儿溶血伴高胆红素血症患儿血清指标的调节作用[J].河北医学,2020,26(8):1273-1277.
[13] 杨劲,储节华,曹明鹏,等.ABO新生儿溶血患儿血浆游离及红细胞放散抗体IgG亚型与溶血程度的相关性分析[J].中国输血杂志,2021,34(6):624-627.
[14] 李晓燕,柴建红.免疫性抗体与新生儿溶血病关系的研究进展[J].齐齐哈尔医学院学报,2020,41(8):1006-1008.
[15] 高婉卿,郑必霞,杨劲,等.新生儿Rh溶血病与IgG1、IgG3相关性分析[J].安徽医科大学学报,2019,54(5):789-792.
[16] DE HAAS M,THURIK F F,KOELEWIJN J M,et al.Haemolytic disease of the fetus and newborn[J].Vox Sang,2015,109(2):99-113.

ABO-HDN患儿血型IgG抗体效价及亚型的分布特征分析^*

Analysis of the Distribution Characteristics of IgG Antibody Titers and Subtypes in ABO-HDN

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

编辑推荐

Metrics

本文评价

关于本刊

作者中心

在线期刊

访问统计

联系我们

[1]	杨晓亚, 阳绪华, 高裕华, 赵义曼, 毕利博. 孕妇血清IgG抗A（B）抗体效价积分检测预估母婴ABO血型不合新生儿溶血病价值^*[J]. 临床输血与检验, 2023, 25(4): 484-488.
[2]	段灵, 陈萍, 胡红兵. 直接抗球蛋白试验和总胆红素与白蛋白比值联合检测在ABO新生儿溶血病导致的严重高胆红素血症中的临床意义[J]. 临床输血与检验, 2022, 24(5): 600-604.
[3]	刘鹏, 丁建娥, 姜丹丹, 丁金钰, 邵淑玲, 董秀梅. 血管内皮钙黏蛋白与ABO新生儿溶血病患儿血管内皮损伤的相关性研究[J]. 临床输血与检验, 2022, 24(1): 80-83.