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目的:探讨O型孕妇血型抗体效价与新生儿溶血病和高胆红素血症发生以及蓝光治疗时间关系。方法:根据O型孕妇妊娠20～24周测定的IgG抗A或(和)抗(B)效价,把新生儿分为4组(≤1∶32、1∶64、1∶128、≥1∶256),取脐血进行Coombs实验,游离抗体和抗体释放实验以证实新生儿ABO溶血病,监测新生儿血清胆红素;并采用Fanaroff教授等制定的黄疸干预方案对新生儿进行早期综合治疗。结果:当孕妇血型抗体效价为≤1∶32、1∶64、1∶128和≥1∶256时,各组新生儿ABO溶血病的发生率分别为11 1%、13 5%、22 0%和52 9%;高胆红素血症发生率为33 3%、37 8%、46 0%和76 5%;蓝光照射时间为(7 1±3 8)、(10 9±7 7)、(17 7±9 6)和(37 1±18 7)h。结论:随着孕妇IgG抗体效价增高,新生儿ABO溶血病和高胆发生率升高,需要蓝光干预的时间延长。
Objective: To investigate the relationship between the blood group antibody titer of O-pregnant women and the occurrence of hemolytic disease and hyperbilirubinemia in neonates and the duration of blue light therapy. Methods: Neonates were divided into four groups (≤1:32, 1:64, 1:128, ≥1) according to the IgG anti-A or (anti) (B) titer measured at 20-24 weeks of pregnancy of O-type pregnant women : 256), cord blood was taken for Coombs test, free antibody and antibody release test to confirm neonatal ABO hemolytic disease, neonatal serum bilirubin monitoring; and Professor Fanar jaundice intervention program for neonatal early comprehensive treatment . Results: When the blood group antibody titers of pregnant women were ≤1: 32, 1:64, 1:128 and ≥1: 256, the incidences of neonatal ABO hemolytic disease in each group were 11 1%, 135%, 220 % And 52 9% respectively. The incidence of hyperbilirubinemia was 33.3%, 37.8%, 46.0% and 76.5% respectively. The duration of blue light irradiation was (71 ± 38) and (109 ± 7 7) , (17 7 ± 96) and (37 1 ± 18 7) h, respectively. CONCLUSION: With the increase of IgG antibody titer in pregnant women, ABO hemolytic disease and hypercholesterolemia in neonates are increased, and the time of blue light intervention is needed.