目的:分析不规则抗体所致新生儿溶血病(hemolytic disease of newborn,HDN)的抗体检测意义及其分布特点,为临床HDN的明确诊断和治疗措施提供依据.方法:选取102例在医院检测并证实为非ABO-HDN病例,收集患儿致病抗原体、日龄、是否输血、是否合并ABO-HDN以及母亲妊娠史、输血史等资料,分析其分布特点.结果:102例患儿中,Rh系统85例(83.33％),MNS系统14例(13.73％),Kidd系统3例(2.94％).母亲有妊娠史78例(76.47％);有输血史15例(14.71％);男58例(56.86％),女44例(43.14％);合并ABO-HDN 14例(13.73％),未合并88例(86.27％).非ABO-HDN患儿不规则抗体常见于Rh系统的抗-D抗体,占比47.06％,其次为抗-E抗体,占比17.65％,以Kidd系统最少,占比2.94％;37℃反应性:1+～4+;免疫球蛋白(Ig)类型:IgG类93例,IgG+IgM类3例,IgM类6例.分析患儿各类指征与输血的相关性显示,患儿合并ABO-HDN与输血有关(P＜0.05),与母亲妊娠史、患儿性别、抗体特异无关(P＞0.05).结论:不规则抗体所致HDN患儿多见于Rh系统的抗-D和抗-E抗体,37℃反应性:1+～4+,Ig类型主要为IgG类,合并ABO-HDN患儿与输血有关,应及时进行HDN抗体检测,根据检测结果及时临床干预,以降低HDN的病死率.
Detection and distribution of irregular antibodies to hemolytic disease in newborns
Objective:To Analyze the significance and distribution characteristics of antibody detection in neo-natal hemolytic disease(HDN)caused by irregular antibodies,providing a basis for the clear diagnosis and treat-ment of clinical HDN.Methods:102 cases of non ABO-HDN detected and confirmed in the hospital were select-ed,and data on the pathogenic antigen,age,whether blood transfusion was performed,whether combined with ABO-HDN,as well as maternal pregnancy and blood transfusion history were collected to analyze their distribu-tion characteristics.Results:Among the 102 children,there were 85 cases(83.33％)with Rh system,14 cases(13.73％)with MNS system,and 3 cases(2.94％)with Kidd system.78 cases(76.47％)had a mother's history of pregnancy;15 cases(14.71％)had a history of blood transfusion;58 males(56.86％)and 44 females(43.14％);14 cases(13.73％)were combined with ABO-HDN,and 88 cases(86.27％)were not combined.Irregular antibodies in non ABO-HDN children were commonly found in the Rh system's anti D antibodies,accounting for 47.06％,followed by anti E antibodies,accounting for 17.65％,with the Kidd system being the least common,accounting for 2.94％;37 ℃ reactivity:1+to 4+;Immunoglobulin(Ig)types:93 cases of IgG,3 cases of IgG+IgM,and 6 cases of IgM.Analysis of the correlation between various indications and blood trans-fusion in children showed that the presence of ABO-HDN was associated with blood transfusion(P＜0.05),while maternal pregnancy history,child gender,and antibody specificity were not associated with it(P＞0.05).Conclu-sion:Irregular antibodies causing HDN in children were commonly seen in the Rh system with anti D and anti E antibodies.The reactivity at 37 ℃ was 1+to 4+,and the Ig type was mainly IgG.Patients with ABO-HDN should undergo timely detection of neonatal HDN antibodies and clinical intervention based on the test results to reduce the mortality rate of HDN.
hemolytic disease of newbornirregular antibodyantibody detectiondistribution characteristics
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