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临床输血与检验

临床输血与检验 ›› 2025, Vol. 27 ›› Issue (4): 451-456.DOI: 10.3969/j.issn.1671-2587.2025.04.003

• 临床输血 • 上一篇    下一篇

孕期母亲血浆抗-M抗体对M抗原阳性红细胞凋亡速率的影响*

梁延连1, 梁耀鹏2, 唐雄驰3   

  1. 1深圳市血液中心输血医学研究所,广东深圳 518040;
    2南方医科大学,广东广州 510515;
    3广西平南县人民医院,广西平南 537300
  • 收稿日期:2025-02-11 出版日期:2025-08-20 发布日期:2025-08-22
  • 作者简介:梁延连,主要从事输血医学与免疫遗传学研究,（E-mail）liangyanlian@126.com。
  • 基金资助:
    *本课题受深圳市医疗卫生三名工程（No.SZSM202311032）、深圳市输血医学重点学科（No.SZXK070）、广西医疗卫生重点培育学科[No.平南县人民医院消化内科 2022（二）：10]项目资助

The Influence of Plasma Anti-M Antibody of Pregnant Mothers on the Apoptosis Rate of M Antigen-positive Red Blood Cells

LIANG Yanlian1, LIANG Yaopeng2, TANG Xiongchi3   

  1. 1Institute of Transfusion Medicine, Shenzhen Blood Center, Shenzhen 518040;
    2Southern Medical University, Guangzhou 510515;
    3Pingnan County People's Hospital of Guangxi, Pingnan 537300
  • Received:2025-02-11 Online:2025-08-20 Published:2025-08-22

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摘要： 目的 分析孕期母体血浆抗-M抗体致围产期M抗原阳性胎儿与新生儿严重贫血以及输血的风险,探讨抗-M抗体对M抗原阳性红细胞凋亡速率的影响。方法 以血清学方法鉴定孕期母亲及胎儿脐带血、新生儿的ABO、RhD、MN血型与Coombs试验。实验组：含抗-M抗体的3位母体血浆分别与ABO同型的献血者MN型红细胞;对照组：不规则抗体鉴定阴性的AB型血浆与AB型献血者MN型红细胞。模拟人体内环境进行体外培养,监测24 h、48 h、72 h的M抗原阳性红细胞凋亡速率。结果 3位母体血浆中均存在抗-M抗体并导致了胎儿在宫内或新生儿出生后的严重贫血。模拟人体内环境监测24 h、48 h、72 h的M抗原阳性红细胞凋亡速率,对照组：1.46%、3.35%、29.7%;实验组的母亲1血浆：3.17%、42.8%、73.9%;母亲2血浆：4.68%、32.1%、59.2%;母亲3血浆：4.15%、33.7%、69.3%。与对照组相比,孕期母亲血浆抗-M抗体可诱导M抗原阳性红细胞在72 h内加速凋亡,抗-M抗体效价越高,M抗原阳性红细胞凋亡速率越快。结论 孕期母亲血浆抗-M抗体可引起胎儿与新生儿严重贫血,有加快M抗原阳性红细胞凋亡的能力。应选择M抗原阴性红细胞输血,以避免不良输血反应的危害。

关键词: 同种免疫, 胎儿与新生儿贫血, 抗-M抗体, 红细胞凋亡速率

Abstract: Objective To analyze the risk of severe anemia and blood transfusion in perinatal M antigen-positive fetuses and neonates caused by maternal plasma anti-M antibodies during pregnancy, and to explore the effect of anti-M antibodies on the apoptosis rate of M antigen-positive red blood cells. Methods Serological methods were used to identify the ABO, RhD, MN blood types of umbilical cord blood of pregnant mothers and fetuses, as well as the Coombs test of newborns. Experimental group: The plasma of three mothers containing anti-M antibodies was respectively compared with the MN-type red blood cells of blood donors with the same ABO type; Control group: AB-type plasma with negative irregular antibody identification and MN-type red blood cells from AB-type blood donors. In vitro culture was carried out by simulating the in vivo environment of the human body to monitor the apoptosis rate of M antigen-positive red blood cells at 24 hours, 48 hours and 72 hours. Results Anti-M antibodies were present in the plasma of all three mothers, which led to severe anemia in the fetus in utero or after the birth of the newborn. The apoptosis rates of M antigen-positive red blood cells at 24 hours, 48 hours and 72 hours were monitored by simulating the in vivo environment of the human body. In the control group: 1.46%, 3.35%, 29.7%; Plasma of mothers in the experimental group: 3.17%, 42.8%, 73.9%; Mother's plasma 2:4.68%, 32.1%, 59.2%; Mother 3 plasma: 4.15%, 33.7%, 69.3%. Compared with the control group, the plasma anti-M antibody of pregnant mothers can induce the accelerated apoptosis of M antigen-positive red blood cells within 72 hours. The higher the titer of the anti-M antibody, the faster the apoptosis rate of M antigen-positive red blood cells. Conclusion Anti-M antibodies in the plasma of pregnant mothers can cause severe anemia in fetuses and newborns, and have the ability to accelerate the apoptosis of M antigen-positive red blood cells. Select M antigen-negative red blood cells for blood transfusion to avoid the harm of adverse blood transfusion reactions.

Key words: Isoimmunity, Fetal and neonatal anemia, Anti-M antibody, Erythrocyte apoptosis rate

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