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目的探讨O型孕妇血清抗-A(B)IgG亚类水平与新生儿溶血病(HDN)的关系。方法采用血型血清学方法 ,对385名夫妇血型不合的O型孕妇血清行抗-A(B)IgG效价测定,并对其中有妊娠史的274名孕妇行IgG抗体水平比较;采用ELISA法对92例HDN患儿及其母亲,75名健康O型孕妇和61名健康新生儿的IgG亚类行定量分析。结果 385名新生儿中发生ABOHDN92例(23.8%),其中抗-A36例、抗-B56例;随着妊娠次数的增加,IgG抗体效价≥64者的比例和ABOHDN发病率升高,第2次妊娠与>2次妊娠之间有统计学差异;患儿及其母亲体内IgG抗体水平显著高于健康对照组,且以IgG1抗体为主,患儿体内IgG1比例(71.3%)高于母体(63.7%)。结论新生儿ABOHDN的发病率随其母体效价的升高而升高。夫妇血型不合的O型孕妇应定期检测其IgG抗体及其亚类水平。
Objective To investigate the relationship between serum anti-A (B) IgG subclass level and neonatal hemolytic disease (HDN) in type-O pregnant women. Methods Serum anti-A (B) IgG titer of 385 pregnant women with O-type maternal incompetence was determined by serological method. The IgG antibody levels of 274 pregnant women with pregnancy were compared. Quantitative analysis of IgG subclasses in 92 HDN children and their mothers, 75 healthy O pregnant women and 61 healthy newborns. Results Among the 385 newborns, 92 (23.8%) had ABOHDN, of which anti-A36 and anti-B56. With the increase of the number of pregnancy, the IgG antibody titer≥64 and the incidence of ABOHDN increased. There was a significant difference between the second trimester pregnancy and the second trimester pregnancy. The level of IgG antibody in the infants and their mothers was significantly higher than that in the healthy controls, and the IgG1 antibody was the major component. The proportion of IgG1 in the infants (71.3%) was higher than that in the maternal 63.7%). Conclusion The incidence of neonatal ABOHDN increases with the increase of maternal titers. O-pregnant women with different blood type should regularly test their IgG antibodies and their subclasses.