新生儿Rh溶血病与IgG1、IgG3相关性分析
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摘要
目的研究Rh血型系统新生儿溶血病与IgG1、IgG3的相关性。方法研究Rh-HDN患儿64例。新生儿出生后抽取患儿及其母亲外周静脉血,检测患儿母亲Rh系统抗体、患儿IgG亚型以及血清总胆红素、间接胆红素水平,分析患儿不同IgG亚型与其血清总胆红素、间接胆红素水平的相关性,并分析不同Rh系统抗体对患儿血清总胆红素、间接胆红素水平的影响。结果 Rh系统抗-D占65.63%,抗-E(包括Rh-E、Rh-cE)占26.56%,引起新生儿Rh-HDN发病的IgG抗体亚型主要为IgG1(23例,35.94%)、IgG1、3(35例,54.68%)两类。IgG1、3组患儿血清总胆红素、间接胆红素水平明显高于IgG1或IgG3组(P<0.05)。Pearson相关性分析显示:患儿血清总胆红素、间接胆红素水平与患儿IgG1水平和IgG1、3水平呈显著正相关(P<0.05),与患儿IgG3水平无显著相关性;抗-D组患儿血清总胆红素、间接胆红素水平明显高于非抗-D组(P<0.05)。结论新生儿Rh溶血症患儿黄疸严重程度与IgG水平呈显著正相关,对于疑有Rh溶血症的患儿,进行IgG1或IgG1、3水平的检测,对该类患儿早期治疗有指导意义。
Objective To study the correlation between hemolytic disease and IgG1 and IgG3 in Rh blood group system. Methods The subjects were Rh-HDN children. The newborn venous blood of the child and its mother was taken after birth, and the mother Rh system antibody, the IgG subtype of the child, the serum total bilirubin and the indirect bilirubin level were detected, and the different IgG subtypes and serum totals were analyzed. The correlation between bilirubin and indirect bilirubin levels, and the effects of different Rh system antibodies on serum total bilirubin and indirect bilirubin levels in children. Results Anti-D of Rh system accounted for 65.63%, anti-E(including Rh-E, Rh-cE) accounted for 26.56%, and the IgG antibody subtype of neonatal Rh-HDN was mainly IgG1(23 cases, 35.94%), IgG1, 3(35 cases, 54.68%) two categories. Serum total bilirubin and indirect bilirubin levels were significantly higher in IgG1 and 3 groups than in IgG1 or IgG3 groups(P<0.05). Pearson correlation analysis showed that there was a significant positive correlation between serum total bilirubin and indirect bilirubin levels and IgG1 levels and IgG1 and 3 levels(P<0.05), and no significant correlation with IgG3 levels in children. Serum total bilirubin and indirect bilirubin levels were significantly higher in the anti-D group than that in the non-anti-D group(P<0.05). Conclusion The severity of jaundice in neonates with Rh hemolytic disease is significantly positively correlated with IgG level. For children with suspected Rh hemolytic disease, IgG1 or IgG1 and 3 levels are detected, which is helpful for early treatment of this type of children.
Objective To study the correlation between hemolytic disease and IgG1 and IgG3 in Rh blood group system. Methods The subjects were Rh-HDN children. The newborn venous blood of the child and its mother was taken after birth, and the mother Rh system antibody, the IgG subtype of the child, the serum total bilirubin and the indirect bilirubin level were detected, and the different IgG subtypes and serum totals were analyzed. The correlation between bilirubin and indirect bilirubin levels, and the effects of different Rh system antibodies on serum total bilirubin and indirect bilirubin levels in children. Results Anti-D of Rh system accounted for 65.63%, anti-E(including Rh-E, Rh-cE) accounted for 26.56%, and the IgG antibody subtype of neonatal Rh-HDN was mainly IgG1(23 cases, 35.94%), IgG1, 3(35 cases, 54.68%) two categories. Serum total bilirubin and indirect bilirubin levels were significantly higher in IgG1 and 3 groups than in IgG1 or IgG3 groups(P<0.05). Pearson correlation analysis showed that there was a significant positive correlation between serum total bilirubin and indirect bilirubin levels and IgG1 levels and IgG1 and 3 levels(P<0.05), and no significant correlation with IgG3 levels in children. Serum total bilirubin and indirect bilirubin levels were significantly higher in the anti-D group than that in the non-anti-D group(P<0.05). Conclusion The severity of jaundice in neonates with Rh hemolytic disease is significantly positively correlated with IgG level. For children with suspected Rh hemolytic disease, IgG1 or IgG1 and 3 levels are detected, which is helpful for early treatment of this type of children.
引文
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[3] 刘淑均,沈继龙,卞茂红,等.利用噬菌体随机肽库筛选Rh(D)血型抗原的模拟表位[J].安徽医科大学学报,2013,48(7):817-20.
[4] Strauss R G,Storry J R .More data needed to establish maternal breast milk IgG as cause for anti-D hemolytic disease of fetus and newborn[J].Transfusion,2018,58(3):828-33.
[5] 叶海辉,黄洪海,王晓霖,等.孕妇IgG效价与不同血型新生儿溶血并发症的相关性分析[J].中国实验血液学杂志,2017,25(5):1532-6.
[6] 毛雨生,陈靖,王从刚,等.IgG型抗-D引起的新生儿溶血病1例[J].中国输血杂志,2016,37(21):417-22.
[7] Quantock K M,Lopez G H,Hyland C A,et al.Anti-Din a mother,hemizygous for the variant RHD*DNB gene,associated with hemolytic disease of the fetus and newborn[J].Transfusion,2017,57(8):245-8.
[8] 侯玉涛,童书青,刘凯,等.Rh系统新生儿溶血病与IgG抗体亚类的相关性研究[J].中国输血杂志,2017,30(4):366-8.
[9] 宋小川,居敏,许洁,等.新疆地区RhD阴性孕妇血清IgG抗-D筛查与效价检测的分析[J].中国输血杂志,2015,28(11):1374-6.
[10] 安莹花,刘莹,刘小艳,等.O型血孕妇IgG抗A(B)效价检测与新生儿溶血病相关性分析[J].临床医学研究与实践,2017,68(13):174-8.
[2] Fasano R M .Hemolytic disease of the fetus and newborn in the molecular era[J].Semin Fetal Neonatal Med,2016,21(1):28-34.
[3] 刘淑均,沈继龙,卞茂红,等.利用噬菌体随机肽库筛选Rh(D)血型抗原的模拟表位[J].安徽医科大学学报,2013,48(7):817-20.
[4] Strauss R G,Storry J R .More data needed to establish maternal breast milk IgG as cause for anti-D hemolytic disease of fetus and newborn[J].Transfusion,2018,58(3):828-33.
[5] 叶海辉,黄洪海,王晓霖,等.孕妇IgG效价与不同血型新生儿溶血并发症的相关性分析[J].中国实验血液学杂志,2017,25(5):1532-6.
[6] 毛雨生,陈靖,王从刚,等.IgG型抗-D引起的新生儿溶血病1例[J].中国输血杂志,2016,37(21):417-22.
[7] Quantock K M,Lopez G H,Hyland C A,et al.Anti-Din a mother,hemizygous for the variant RHD*DNB gene,associated with hemolytic disease of the fetus and newborn[J].Transfusion,2017,57(8):245-8.
[8] 侯玉涛,童书青,刘凯,等.Rh系统新生儿溶血病与IgG抗体亚类的相关性研究[J].中国输血杂志,2017,30(4):366-8.
[9] 宋小川,居敏,许洁,等.新疆地区RhD阴性孕妇血清IgG抗-D筛查与效价检测的分析[J].中国输血杂志,2015,28(11):1374-6.
[10] 安莹花,刘莹,刘小艳,等.O型血孕妇IgG抗A(B)效价检测与新生儿溶血病相关性分析[J].临床医学研究与实践,2017,68(13):174-8.