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目的分析O型Rh阳性血围产期孕妇同种免疫发生情况和新生儿溶血病的检测情况,了解本地区O型阳性孕产妇的胎儿与新生儿溶血病(HDFN)的发病情况。方法对1 920例O型血孕妇的丈夫进行ABO及RhD血型鉴定,对夫妇血型不合的1 468例孕妇进行产前抗体效价监测;母婴血型不合261例患儿进行新生儿溶血病三项检测[直接抗人球蛋白(直抗)试验、游离试验、放散试验]和总胆红素测定。结果在1 920例O型血孕妇中,夫妇血型不合者1 468例(76.5%),其中O-A型597例,O-B型688例,O-AB型183例;相合者452例(23.5%)。对血型不合的孕妇进行血型抗体效价测定,孕妇血清中IgG抗A(B)效价≥1∶64为阳性时,其阳性率为69.5%。并对261例中117例A型母婴血型不合新生儿、126例B型母婴血型不合新生儿和18例Rh(D)阴性母婴血型不合新生儿进行游离试验、直抗试验、放散试验测定,其阳性例数分别为111例(42.5%)、64例(24.5%)和163例(62.5%)。溶血试验阳性的患儿高胆红素血症的发病率分别为:游离试验30.6%、直抗试验65.6%、放散试验69.9%。结论将产前围产期孕妇的血型抗体效价监测和产后新生儿溶血三项及高胆红素的测定结合起来进行观察、预防、治疗,能有效降低对新生儿的损害,对早期诊断HDFN、防治胆红素脑病的发生具有重要意义。
Objective To analyze the status of alloimmunization and hemolytic disease in O-positive Rhino-positive pregnant women and to find out the incidence of fetal and neonatal hemolytic disease (HDFN) in O-positive pregnant women in this area. Methods A total of 1 920 pregnant women with type O blood were tested for ABO and RhD blood type. Prenatal antibody titer was detected in 1468 pregnant women with incompatible blood type. Three hundred and sixty-one neonates with hemolytic disease Test [Direct anti-human globulin (direct anti-anti) test, free test, elution test] and total bilirubin assay. Results Among 1 920 pregnant women with O-type blood, 1468 (76.5%) were blood type incompatibility. Among them, 597 were type O-A, 688 were type O-B and 183 were type O-AB. Blood group antibody titer determination of pregnant women with different blood groups, pregnant women serum IgG anti-A (B) titer ≥ 1:64 is positive, the positive rate was 69.5%. 117 cases of type A maternal and infant non-newborn, 126 cases of type B maternal and neonatal unborn babies and 18 cases of Rh (D) negative maternal and neonatal unborn babies were tested for free test, direct test, The positive cases were 111 cases (42.5%), 64 cases (24.5%) and 163 cases (62.5%) respectively. Hemolysis test positive children with hyperbilirubinemia incidence rates were: free test 30.6%, straight anti-test 65.6%, discharge test 69.9%. Conclusion The observation, prevention and treatment of blood group antibody titers and postpartum neonatal hemolytic titers and hyperbilirubin in prenatal perinatal period can effectively reduce the damage to neonates. It is of great value to early diagnosis of HDFN , Prevention and treatment of bilirubin encephalopathy is of great significance.