邱　丽，苗　温，白　虹（.天津医科大学基础医学院免疫学系，天津　300070；.天津市滨海新区塘沽中心血站，天津　300456）



O型孕妇产前IgG抗－A（B）抗体效价变化分析

邱丽1，苗温2，白虹1
（1.天津医科大学基础医学院免疫学系，天津300070；2.天津市滨海新区塘沽中心血站，天津300456）

摘要目的：探讨O型孕妇产前IgG抗－A（B）抗体效价的变化及其拐点的出现时间。方法：使用经典抗球蛋白试验检测2 777 名O型孕妇血清中IgG抗－A（B）抗体效价，并按妊娠次数、孕周进行结果分析。结果：随着妊娠次数的增加，血清中IgG抗－A （B）抗体水平也不断增高，首次妊娠与2次及以上妊娠孕妇血清IgG抗－A（B）抗体效价相比均存在显著性差异（P＜0．01）；随着孕周的增加，血清中IgG抗－A（B）抗体水平在16～19周时缓慢增高，在妊娠20周时出现一个明显增高的拐点，而后继续增高并在孕24～28周时达到峰值，随后不再增长。结论：O型孕妇在妊娠20周时应进行IgG抗－A（B）抗体效价检测，具有多次妊娠史的O型孕妇，体内可能存在高效价的IgG抗－A（B）抗体，应及时进行抗体检测。

关键词IgG抗－A（B）抗体；新生儿溶血病；拐点

Analysis of IgG anti -A(B)antibody titers in type O pregnant women

QIU Li1，MIAO Wen2，BAI Hong1
（1.Department of Immunology,School of Basic Medical Sciences,Tianjin Medical University,Tianjin 300070,China；2.Binhai Tanggu Blood Station,Tianjin 300456,China）

Abstract Objective:To investigate the changes and turning point of IgG anti-A(B)antibody titers in type O pregnant women.Methods：IgG anti-A(B)antibody titers of 2 777 type O pregnant women were tested by the classic antiglobulin test and the results were analyzed according to the number of pregnancy and gestational weeks.Results：With the increase of the number of pregnancy,serum IgG anti -A(B)antibody levels were also increased,and significant difference was found in IgG anti -A(B)antibody titers between the first pregnancy and the two or multiple pregnant women（P＜0.01）.With the increase of gestational weeks,serum IgG anti -A(B)antibody level was first increased slowly in 16-19 weeks of pregnancy,with a turning point of marked increase at 20 weeks of pregnancy，after which continued to increase to peak at 24-28 weeks of pregnancy,without any further growth.Conclusion：The type O pregnant women should undergo IgG anti-A(B)antibody titers detection at 20 weeks of pregnancy.The group O pregnant women with multiple pregnancy history should carry out IgG anti -A(B)antibody test in time,because high titer antibodies may exist in their sera.

Key words IgG anti-A(B)antibody；haemolytic disease of the newborn；turning point

新生儿溶血病（haemolytic disease of the newborn,HDN）一般特指母婴血型不合引起的胎儿或新生儿同种免疫性溶血性疾病，现已列为孕妇围产期保健的重要内容。新生儿溶血病较多发生于ABO和Rh血型系统，虽然ABO-HDN的溶血表现相对于Rh-HDN较温和[1]，但在我国的HDN以ABO系统居多（85.3%），Rh系统较少（14.6%），MNSs系统罕见（0.1%）[2]。近年Meta分析显示随着孕妇IgG抗-A(B)抗体效价的升高，发生HDN的概率也增高[3]。而产前IgG抗－A（B）抗体效价检测可用于判断ABOHDN发病的风险，是预防ABO-HDN发生的一个重要参考指标[4]。因此对O型孕妇进行血清IgG抗-A （B）抗体效价的检测，了解其上升速度及影响因素，对于预防、诊断和治疗ABO系统新生儿溶血病有重要意义。……