【作者】 朱颖；

【导师】 毛慧玲；

【作者基本信息】 南昌大学 ， 微生物学， 2010， 硕士

【摘要】 目的：当孕妇血型与体内胎儿血型不合时,可能导致新生儿溶血病(hemolytic disease of newborn,HDN)的发生。一旦发生HDN,患儿出现贫血、黄疸(核黄疸)、肝脾肿大甚至水肿等症状,如果不及时治疗可引起新生儿死亡。在临床上尤以ABO血型不合引起的HDN最为常见。因此,对孕妇血清中的IgG抗A.(B)效价进行监测,可以对ABO HDN的发生发展进行有效的预防以及为临床提供辅助诊断。方法：采用经典的抗人球蛋白试验和改良的抗人球蛋白试验两种方法,对303例夫妇ABO血型不合(O/A、O/B、O/AB)的O型孕妇血清中IgG抗A(B)效价进行测定,通过对实验数据进行分析,并对效价≥1：64的孕妇进行追踪监测,探讨此两种方法在预防新生儿溶血病中的差异及临床应用。1.用经典的抗人球蛋白试验和改良的抗人球蛋白试验测定303例孕妇血清中IgG抗A(B)效价并计算出两种方法的阳性率并做统计学分析。2.以经典法为标准,利用统计学软件计算出改良法的特异度和敏感度。3.对效价≥1：64的孕妇进行追踪监测。结果：1.阳性率：经典的抗人球蛋白试验法为16.17%；改良的抗人球蛋白试验法为17.49%,SPSS 13.0统计学软件分析,两者的差异无统计学意义(P>0.05)。2.以经典的抗人球蛋白试验法为标准,改良法的敏感度和特异度分别为97.96%和99.61%。3.48例孕妇效价≥1：64,治疗一个月后,46例效价<1：64,另2例继续治疗直至临产仍≥1：64(1例效价≥1：128,另1例效价≥1：256)。结论：经典和改良的抗人球蛋白试验在检测孕妇血清中IgG抗A(B)效价的检测结果上具有良好的一致性,但改良后的方法更为快速,.操作更为简便,值得临床推广更多还原

【Abstract】 Objective:When the pregnant women’s blood group is incompatibility with the embryo’s in its body, the hemolytic disease of newborn (HDN) may be happened. Once the HDN happened, the anemia、jaundice (Nuclear jaundice)、Hepatosplenomegaly even edema will happened to the illed-chidren. If there is no therapy in time, the illed-children may be going to die. HDN which caused by ABO blood group incompatibility was most commonly in clinical. Therefore, during the time of pregnancy, to detect the Anti-A (B) IgG Titers of Pregnant Women, can offer the auxiliary diagnosis of HDN’s occurrence and development, and can also offer the effective prophylaxis.Methods:Adopt both classic Coombs Test and Improved Coombs Test of the Anti-A(B) IgG Titers of 0 blood group Pregnant Women whose BG is different with their husbands(O/A、O/B、O/AB), through the analysis of test data and to track the Suspected cases,to discuss the application in clinical and the difference between these two metheods in preventing the occurrence of ABO HDN.1. To detect the Anti-A (B) IgG Titers of 303 Pregnant Women’s serium by classical coombs test and improved coombs test and calculate the positive rates of these two methods, and then give the statistic analysis between these two methods.2. Use the statistic software to calculate the specificity and sensitivity of improved coombs test as the classical coombs test to be the standard.3. To trace and monitor the samples that the Titer is>1:64.Results:1. The positive rate:classical coombs test is 16.17%, the improved coombs test is 17.49%. There is no statistic significant of these two methods by the SPSS 13.0 software.2. As the classical coombs test to be the standard, the specificity and sensitivity of the improved coombs test is 98.96% and 99.39%.3.48 samples’Titers are≥1:64. After one month treatment,46 samples are recoverd. The other two samples be cured till delivery but the titers still>1:64(one is≥1:128, the other one is≥1:256). Conclusion:There is a good consistency of the determination of Anti-A(B) IgG Titers of Pregnant Women between the classitical and improved coombs tests, but the improved coombs test can use less time,and much more simple and convenient in its operating than the classical coobms test,so it deserved to spread in clinical.更多还原