Cheng Chen, Zhang Yi, Chen Yi-Jing, Luo Qun, Zhuo Hai-Long
Department of Blood Transfusion， The Fifth Medical Center of PLA General Hospital, Beijing 100071, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Dec;32(6):1903-1908. doi: 10.19746/j.cnki.issn.1009-2137.2024.06.041.
To analyze the diagnostic value of IgG anti-A/anti-B antibody titer in the serum of type O pregnant women after absorption of IgG anti-AB antibody for ABO hemolytic disease of fetus and newborn (ABO-HDFN).
From February 2020 to September 2020, 235 samples of neonatal hemolytic disease whose mother's blood type O from Beijing Blood Center were selected. The titer of IgG anti-A/anti-B antibody in mother's serum before and after absorption of IgG anti -AB antibody was detected by microcolumn gel card, and the incidence of ABO-HDFN was statistically analyzed. The titer level of IgG anti-A/ant-B antibody and the incidence of ABO-HDFN were compared before and after the absorption of IgG anti-AB antibody, and the diagnostic efficacy of the titer level of IgG anti -A/anti-B antibody in the serum of type O pregnant women after the absorption of IgG anti-A and B antibodies on the incidence of ABO-HDFN was analyzed using the receiver's work characteristic (ROC) curve.
Of the 235 neonatal hyperbilirubinemia samples with maternal blood type O, 127 were blood type A, 38 of which were diagnosed as ABO-HDFN; 108 were blood type B, of which 31 were diagnosed as ABO-HDFN. Before and after absorption of IgG anti-AB antibody, there was a significant difference in the titer of IgG anti-A/anti-B antibody ( < 0.05). Among the 69 confirmed cases, the incidence of ABO-HDFN increased with the increase of IgG anti-A/anti-B antibody with or without the IgG anti-AB antibody, but the anti-A/anti-B antibody titer ≥1∶512 before the absorption of IgG anti-AB antibody, while the anti-A/anti-B antibody titer decreased significantly, decreasing by three titers, all≤1∶512. The ROC curve shows that the titers of IgG anti-A/anti-B antibodies before and after absorption of IgG anti-AB antibodies can be used as the efficacy indicators for the diagnosis of ABO-HDFN. However, there was a significant difference in the potency of IgG anti-A/anti-B antibody titer for the diagnosis of ABO-HDFN before and after the absorption of IgG anti-AB antibody ( < 0.05). The AUC values were greater than before absorption, indicating that the IgG anti-A/anti-B antibody after the absorption of IgG anti-AB antibody was better than before absorption ( < 0.05).
The higher the titer of IgG anti-A/anti-B antibody measured after absorbing IgG anti-AB antibody, the higher the incidence of ABO-HDFN. In addition, the efficacy of IgG anti-A/anti-B antibody titer to diagnose ABO-HDFN after absorption of IgG anti-AB antibody is higher than that before absorption.
分析O型孕妇血清中IgG抗A/抗B抗体效价在吸附IgG抗AB抗体后对胎儿及新生儿ABO溶血病（ABO-HDFN）的诊断价值。
选取2020年2月至2020年9月北京市血液中心采集的235例母亲血型为O型的新生儿溶血病样本。采用微柱凝胶卡检测母亲血清在吸附IgG抗AB抗体前后的IgG抗A/抗B抗体效价，并对ABO-HDFN的发病率进行统计学分析。比较吸附IgG抗AB抗体前后IgG抗A/抗B抗体效价水平及ABO-HDFN的发病率，利用受试者工作特征（ROC）曲线分析O型孕妇血清在吸附IgG抗A和B抗体后IgG抗A/抗B抗体效价水平对ABO-HDFN发病率的诊断效能。
在235例母亲血型为O型的新生儿高胆红素血症样本中，A型127例，其中38例诊断为ABO-HDFN；B型108例，其中31例诊断为ABO-HDFN。吸附IgG抗AB抗体前后，IgG抗A/抗B抗体效价差异有统计学意义（<0.05）。在69例确诊病例中，无论有无IgG抗AB抗体，ABO-HDFN的发病率均随IgG抗A/抗B抗体效价升高而增加，但吸附IgG抗AB抗体前抗A/抗B抗体效价≥1∶512，吸附后抗A/抗B抗体效价显著下降，下降三个滴度，均≤1∶512。ROC曲线显示，吸附IgG抗AB抗体前后的IgG抗A/抗B抗体效价均可作为诊断ABO-HDFN的效能指标。然而，吸附IgG抗AB抗体前后IgG抗A/抗B抗体效价对ABO-HDFN诊断效能差异有统计学意义（<0.05）。曲线下面积（AUC）值大于吸附前，表明吸附IgG抗AB抗体后的IgG抗A/抗B抗体优于吸附前（<0.05）。
吸附IgG抗AB抗体后检测的IgG抗A/抗B抗体效价越高，ABO-HDFN的发病率越高。此外，吸附IgG抗AB抗体后IgG抗A/抗B抗体效价诊断ABO-HDFN的效能高于吸附前。
