Cederqvist L L, Francis L C, Zervoudakis I A, Becker C G, Litwin S D
Am J Obstet Gynecol. 1976 Oct 1;126(3):321-7. doi: 10.1016/0002-9378(76)90543-3.
Concentrations of immunoglobulins (Ig)A1, and IgA2, IgD, IgE, IgG, and IgM have been determined in cord blood, amniotic fluid, and maternal serum in a group of patients with a history of prematurely ruptured membranes (PRM) prior to the onset of labor and in a control group of patients undergoing normal delivery and without a history of infection during pregnancy. IgA and IgD were determined by sensitive hemagglutination-inhibition tests; IgG and IgM, by radial immunodiffusion; IgE, by a radioimmunoassay. There was evidence for an immune response in 10 of 16 cases of PRM: five of 16 had increased IgA but normal IgM; three of 16 had increased IgA and IgM; two of 16 had high IgM and normal IgA in cord blood. In patients with significantly increased levels of either IgA or IgM or both, there was a decreased level of IgD. These changes are most likely the result of the immune response to ascending infection from the maternal genitals. The sensitive testing method employed could demonstrate the presence of IgD in 53 per cent of normal cord blood samples and 72 per cent of amniotic fluid samples obtained at term. IgE was found in all normal cord blood and amniotic fluid samples tested. By concentrating the amniotic fluid up to 180-fold, IgM was demonstrated in all normal samples tested. The potential importance of IgA determinations in cord blood in addition to IgM determination for detection of intrauterine infections is stressed.
在一组临产前有胎膜早破（PRM）病史的患者以及一组正常分娩且孕期无感染史的对照患者中，测定了脐带血、羊水和母血中的免疫球蛋白（Ig）A1、IgA2、IgD、IgE、IgG和IgM的浓度。IgA和IgD通过敏感的血凝抑制试验测定；IgG和IgM通过放射免疫扩散法测定；IgE通过放射免疫分析法测定。16例PRM患者中有10例有免疫反应的证据：16例中有5例IgA升高但IgM正常；16例中有3例IgA和IgM升高；16例中有2例脐带血中IgM升高而IgA正常。在IgA或IgM或两者水平显著升高的患者中，IgD水平降低。这些变化很可能是对来自母体生殖道上行感染的免疫反应的结果。所采用的敏感检测方法能够在53%的正常脐带血样本和72%的足月时获得的羊水样本中检测到IgD。在所有检测的正常脐带血和羊水样本中均发现了IgE。通过将羊水浓缩180倍，在所有检测的正常样本中均检测到了IgM。强调了除测定IgM外，测定脐带血中IgA对检测宫内感染的潜在重要性。
