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目的:了解宁波地区O型血孕妇(配偶非O型)产前IgG抗A(B)抗体效价的分布情况,并探讨其与新生儿溶血病(HDN)的关系。方法:采用微柱凝胶法检测孕妇IgG抗A(B)抗体效价及新生儿HDN三项试验,即直接抗人球蛋白试验、游离试验、抗体释放试验。结果:7079例O型孕妇产前IgG抗A(B)抗体效价分布为正偏态分布,IgG抗A(B)抗体效价≥1∶128的孕妇有2848例,占60.0%,其中O-A、O-B、O-AB组孕妇所占比例分别为62.7%、50.2%、74.9%,O-AB组显著高于O-A、O-B组,三组之间均有显著性差异(P<0.01);随着孕妇血清IgG抗A(B)抗体效价的依次递增,ABO HDN的发生率也逐渐升高,不同抗体效价水平间HDN分布存在显著性差异(P<0.01)。结论:O型孕妇产前IgG抗A(B)抗体效价分布呈正偏态分布;ABO HDN的发生率与IgG抗A(B)抗体效价呈正相关,当IgG抗A(B)抗体效价≥1∶128新生儿ABO溶血病的发生率明显升高。
Objective: To investigate the distribution of titers of IgG anti-A (B) antibodies in prenatal O-form pregnant women (spouse non-O type) in Ningbo and to explore their relationship with neonatal hemolytic disease (HDN). Methods: The microcolumn gel method was used to detect the antibody titer of IgG anti-A (B) in pregnant women and neonatal HDN three tests, namely direct anti-human globulin test, free test and antibody release test. Results: The prenatal IgG anti-A (B) antibody titer of 7079 O-pregnant women was positively skewed. There were 2848 pregnant women with IgG anti-A (B) antibody titer ≥1: 128, accounting for 60.0% , OB and O-AB groups were 62.7%, 50.2% and 74.9%, respectively, which were significantly higher in O-AB group than those in OA and OB groups (P <0.01) The antibody titer of IgG anti-A (B) in pregnant women increased gradually, the incidence of ABO HDN increased gradually, and there was a significant difference (P <0.01) in the distribution of HDN between different antibody titers. CONCLUSIONS: Prenatal IgG anti-A (B) antibody titers are positively skewed in type O pregnant women. The incidence of ABO HDN is positively correlated with the titer of IgG anti-A (B) antibody. ≥ 1: 128 neonatal ABO hemolytic disease was significantly higher incidence.