不规则抗体致新生儿溶血病的抗体检测及分布特点
Detection and distribution of irregular antibodies to hemolytic disease in newborns
朱雪 1赵晓丽 1赵德芳1
作者信息
- 1. 长治市人民医院输血科(山西长治,046000)
- 折叠
摘要
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.
Abstract
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.
关键词
新生儿溶血病/不规则抗体/抗体检测/分布特点Key words
hemolytic disease of newborn/irregular antibody/antibody detection/distribution characteristics引用本文复制引用
出版年
2024
NETL
NSTL
万方数据