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目的探讨主动免疫治疗对重症新生儿溶血病(HDN)的预防价值,并提供实验室佐证。方法选择既往有死胎、流产、新生儿重症黄疸史夫妇血型不合的患者63例,随机分成两组,治疗组30例,采用主动免疫治疗加常规中药治疗,对照组采用常规中药治疗;采用酶联免疫(ELISA)法检测妻子血清中的HLA抗体;观察分析免疫治疗对HDN患儿溶血程度的影响。结果孕妇HLA抗体阳性率对照组为21.2%,治疗组为53.3%。二者比较P<0.01,有显著性差异;新生儿发生重症溶血病对照组11例,发生率为33.3%;治疗组1例,发生率为3.3%。二者比较P<0.005,有显著性差异。结论主动免疫治疗能够刺激母体产生HLA抗体;主动免疫治疗能有效预防血型不合所致重症新生儿溶血病的发生;HLA系统参与了HDN的发生发展及预后。
Objective To investigate the value of active immunotherapy in the prevention of severe neonatal hemolytic disease (HDN) and to provide laboratory evidence. Methods Sixty-three patients with history of stillbirth, miscarriage and neonatal severe jaundice were divided randomly into two groups. The treatment group was treated by active immunotherapy plus conventional Chinese medicine. The control group was treated by conventional Chinese medicine. Immunoassay (ELISA) was used to detect HLA antibodies in the serum of the wives. The effect of immunotherapy on the hemolysis in HDN children was observed and analyzed. Results The positive rate of HLA antibodies in pregnant women was 21.2% in the control group and 53.3% in the treatment group. There was a significant difference between the two groups (P <0.01). In the neonatal severe hemolytic disease control group, 11 cases were found, the incidence rate was 33.3%. In the treatment group, the incidence rate was 3.3%. The two compared P <0.005, there are significant differences. Conclusion Active immunotherapy can stimulate maternal HLA antibodies; Active immunotherapy can effectively prevent the occurrence of severe neonatal hemolytic disease due to blood group incompatibility; HLA system is involved in the occurrence, development and prognosis of HDN.