286例RhD阴性孕妇血清IgG抗-D筛查与效价检测的意义

Clinical significance of anti-D IgG screening and titer detection in 286 RhD negative pregnant women

摘要:

目的：RhD阴性孕妇血清IgG抗-D是引起母儿Rh血型不合溶血病的主要抗体。进行孕妇血清IgG抗-D筛查与效价检测，对预测和治疗该病有重要的参考意义。目前国内大规模的检测报道和临床分析不多，该研究对2001年3月至2007 年12月我院RhD阴性孕妇IgG抗-D筛查与效价检测的意义进行回顾性分析。方法：采集286例确认为RhD阴性孕妇的血清，作血型抗体筛查与特异性鉴定，并对抗体阳性患者作定期效价检测。结果：在286例孕妇血清中，IgG抗-D阳性21例,阳性率为7.3%；随着孕期时间的延长，抗体效价有明显增高的趋势。观察12例抗体阳性的胎儿（新生儿），有2例胎儿死亡，2例全程健康；另有8例胎儿（新生儿）出现不同程度的溶血，经换血或输血治疗后，其预后较好。结论： RhD阴性孕妇IgG抗-D筛查与效价测定，对于Rh血型不合新生儿溶血病的预测、治疗具有重要价值。［中国当代儿科杂志，2009，11（3）：185-187］

Abstract:

OBJECTIVE: Anti-D IgG in RhD negative pregnant women is the main antibody of Rh-induced hemolytic disease of newborn (HDN). The study aimed to investigate the clinical significance of anti-D IgG screening and titer detection in RhD negative pregnant women. METHODS: Sera of 286 RhD negative pregnant women were collected. Microtube column indirect antiglobulin test was used to screen and identify anti-D IgG. The indirect antiglobulin test was used to test the titer of anti-D IgG. RESULTS: Anti-D IgG was identified in 21 cases (7.3%). The titer of anti-D showed an increasing trend with pregnancy progresses. The clinical outcomes of 12 fetuses (newborns) from positive anti-D pregnant women were observed. Two cases died in utero, 2 cases did not show abnormality and 8 cases had hemolysis. The 8 cases with hemolysis were treated with exchange transfusion or blood transfusion, and they had a good prognosis. CONCLUSIONS: The screening and titer detection of anti-D IgG in RhD negative pregnant women are valuable in the prediction and treatment of HDN.［Chin J Contemp Pediatr, 2009, 11 (3):185-187］