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摘要: 目的: 分析2 470例妊娠妇女血清中不规则抗体特征,探讨不规则抗体产生的原因以及与妊娠生产不良反应的相关性,为提高产前实验室检查在预防妊娠生产不良反应的应用价值提供实验证据。方法: 通过产前免疫学方法检测妊娠妇女血型、不规则抗体筛查、抗体鉴定及效价等,收集经盐水法、微柱凝胶法确认的不规则抗体定性和分类结果,探讨分析不规则抗体产生可能的原因,以及不规则抗体与妊娠生产不良反应的相关性。结果: 不规则抗体阳性在不同血型中存在差异(P<0.01), 88.89%不规则抗体阳性比率为Rh(D) 阳性,且不规则抗体发生与Rh血型存在关联;既往妊娠生产 ≥ 3次的不规则抗体阳性率最高2.65%,且妊娠与不规则抗体发生存在低相关性;输血患者中不规则抗体发生率明显高于未输血的患者(P<0.01),且输血与不规则抗体发生存在相关性(C=0.262/P=0.00)。不规则抗体阳性的妊娠生产不良反应发生率明显高于不规则抗体阴性的患者,且具有相关性(C=0.305/P=0.00);抗D和抗-HI发生不良反应比率最高;不规则抗体阳性中抗体效价>32的发生不良反应的概率大,且效价与不良反应发生呈相关性。结论: 不规则抗体在妊娠妇女中检出阳性明显预示了妊娠生产不良反应的发生,同时抗体的种类和效价是判断不良反应发生的重要参考指标;不规则抗体产生的原因可能与输血和妊娠次数存在相关性,提示了不规则抗体在临床预警和监测妊娠生产不良反应发生有前瞻性的意义。Abstract: Objective: To explore the cause of arising of irregular antibody (immunity antibody, IA) by checking 2 470 cases pregnant women, and find the lad reference evidence for promoting the eugenics. Method: Blood type, irregular antibody screening, identify and quantify of antibody in pregnant women were determined. The type of IA examined by Brine method and micro column gel method were analyzed, and the reasons of IA arising and the correlation with the adverse reaction of pregnancy and production were explored. Result: IA positive in different blood groups had differences (P<0.01);88.89% of IA positive was the Rh (D) positive, and occurrence of IA was association with Rh blood group. The IA positive ratio of over 4 times pregnancy women was most high, about 2.6%, and had low correlation with pregnancy. The IA positive ratio of transfusion patient was higher than that of no transfusion patient (P<0.01), and had the correlation with transfusion (C=0.262/P=0.00). The incidence of adverse reaction of IA positive pregnant women was apparently higher than that in IA negative pregnant women, and had the correlation with IA (C=0.305/P=0.00). The incidence of adverse reaction in Antibody D and HI was highest. The incidence of adverse reaction of IA titer >32 was higher and had the correlation with IA titer. Conclusion: IA positive could predict the incidence of adverse reaction of pregnancy, and the titer and type of antibody should be considered as factors on appraising the adverse reaction. The cause of arising IA may be transfusion and number of pregnancy. IA could be a good index on predicting and monitoring the adverse reaction of pregnancy.
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