[The Correlation Analysis between the Titer of IgG Anti-A/B Erythrocyte Antibody In Vivo of the Neonate and the Severity of Hemolytic Disease of Newborn]

To investigate the titer of IgG anti-A/B erythrocyte antibody in vivo of the neonate with hemolytic disease of newborn(HDN), and explore its clinical valua in evaluating the severity of HDN.300 neonates with HDN, 50 neonates with neonatal hyperbilirubinemiain and 50 healthy neonates were selected as research object and Microtubes Gel Test was used to detect the titer of IgG anti-A/B erythrocyte antibody in vivo. Their clinical data and their mothers' prenatal examination data were retrospectively analyzed. Three hemolysis tests (direct antiglobulin test, free antibody test and release test), irregular antibody screening, and the titer of IgG anti-A/B blood group antibody was determined by serological method. Red blood cells(RBC), hemoglobin(Hb), reticulocytes(Ret) and nucleated red cells were detected by hematology analyzer. Indirect bilirubin and albumin(Alb) were detected by biochemical analyzer. The relationship between the titer of IgG anti-A/B erythrocyte antibody in vivo and the severity of HDN was analyzed.There were six serological diagnosis modes in the HDN group,the difference between modes was statistically significant (P0.05). The antibody titer relationship between HDN neonates and pregnant women was positive correlation(r=0.8302). The highest antibody titer of release test and free antibody test were 1∶32 and 1∶2, and the difference was statistically significant（P0.05）. RBC, Hb and Alb in HDN patients were lower than those in neonatal hyperbilirubinemia patients and healthy neonates (P0.05), and were negatively relevant with antibody titer in vivo (r=-0.8016). Bilirubin content in HDN patients were higher than those in neonatal hyperbiliru binemia patients and healthy neonates group(P0.05), and was positively relevant with antibody titer in vivo (r=0.8731). The hospital day in HDN patients was significantly relevant with the antibody titer in vivo (r=0.8547), but not with the age, sex, weight and ABO blood types (P0.05).The detection of antibody titer in HDN patients can be used to evaluate the antibody concentration in vivo, predict the ability of antibody to induce erythrocyte hemolysis, and help to judge the serenrity and prognosis of HDN.新生儿体内IgG型血型抗体效价与新生儿溶血病严重程度的相关性分析.研究新生儿体内IgG型ABO血型系统抗体效价，探索其评估新生儿溶血病（HDN)严重程度的临床应用价值.选择400例新生儿为研究对象，分为观察组和对照组。观察组350例包括HDN患者300例和新生儿高胆红素血症患者50例，对照组50例为健康新生儿。分别查阅研究对象的病历资料、产妇产检资料；采用血清学检测方法进行溶血三项试验（直抗试验、游离试验、放散试验）、不规则抗体筛查和血型抗体效价测定，应用血细胞计数仪进行RBC、Hb、Ret、有核红细胞检测，应用生化分析仪进行间接胆红素、Alb含量检测。分析不同IgG型血型抗体效价与HDN严重程度的相关性.HDN患者血清学诊断模式有6种，比较差异有统计学意义（P0.01）。IgG型抗A/B血型抗体游离试验和放散试验阳性患者体内抗体效价与孕妇预期体内效价呈正相关(r=0.8302)，该类患者红细胞放散液抗体效价最高为1∶32,血浆游离抗体效价最高为1∶2,比较差异有统计学意义（P0.05）。HDN患者RBC、Hb、Alb含量与体内抗体效价呈负相关(r=-0.8016)，且低于新生儿高胆红素血症患者和健康新生儿；胆红素含量与体内抗体效价呈正相关(r=0.8731)，且高于新生儿高胆红素血症患者和健康新生儿。HDN患者住院时间与患者体内的抗体效价有明显的相关性(r=0.8547)，与患者年龄、性别、体重、ABO血型无明显的相关性（P0.05）.新生儿体内IgG型抗-A/B抗体效价的测定可以用于评估HDN患者体内抗-A/B抗体含量，能够预测患者体内抗体诱发红细胞溶血的能力，有助于临床判定HDN的严重程度及预后评估.