论文部分内容阅读
目的探讨Rh系统新生儿溶血病(Rh-HDN)与IgG抗体亚类的相关性。方法对50例孕妇产前抗体鉴定为Rh系统同种抗体,患儿出生后抽静脉血做Rh血型、直接coombs试验、游离抗体试验、直抗IgG亚类检测,将抗-D存在时分为1组与其他抗体组比较血清胆红素值,将IgG1、3同时存时分为1组与IgG1或IgG3单独存在时比较血清胆红素值。结果 Rh血型系统5种抗原D、C、c、E、e的相应抗体均可以引起Rh-HDN,其中抗-D(34%)、抗-E(28%)是最常见的抗体,抗-D较其他Rh抗体引起的HDN严重。新生儿直接coombs试验≥2+,游离抗体试验W+-3+,直抗IgG亚类主要为IgG1(38%)或IgG1、3(48%),IgG1、3同时存在时较单种IgG引起的HDN严重,同时发现IgG2和IgG4也能通过胎盘,结合在红细胞上引起HDN。结论抗-D、抗-E是最常见的引起Rh-HDN的Rh抗体,抗-D引起的HDN较严重;引起HDN的IgG亚类主要为IgG1或IgG1、3,IgG1、3同时存在时引起的HDN较严重。
Objective To investigate the relationship between Rh-HDN and IgG subclasses in Rh system. Methods Fifty pregnant women with prenatal antibodies were identified as Rh system alloantibodies. After birth, they were asked to make Rh blood group, direct coombs test, free antibody test and direct anti-IgG subclass test, and the anti-D was divided into 1 Serum bilirubin values were compared with other antibody groups. Serum bilirubin values were compared when IgG1,3 was coexisted into 1 group and IgG1 or IgG3 alone. Results Rh-HDN was induced by the corresponding antibodies of the five antigens D, C, c, E and e of Rh blood group system. Anti-D (34%) and anti-E (28%) were the most common antibodies. Anti- D is more severe than HDN caused by other Rh antibodies. Neonatal direct coombs test ≥ 2 +, free antibody test W + -3 +, direct anti-IgG subclasses are mainly IgG1 (38%) or IgG1,3 (48%), IgG1,3 HDN was severe and IgG2 and IgG4 were also found to cross the placenta and cause HDN on erythrocytes. Conclusion Anti-D and anti-E are the most common Rh antibodies that cause Rh-HDN. HDN caused by anti-D is more serious. The IgG subclass of HDN is mainly caused by IgG1 or IgG1 and IgG1, HDN is more serious.