不同胎龄别体重新生儿ABO血型不合溶血病对器官功能的影响研究

发布时间：2018-03-02 00:30

本文关键词： 新生儿 ABO溶血胎龄影响　出处：《昆明医科大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：回顾性分析196例不同胎龄别体重新生儿ABO溶血病(ABO-HDN)病例。对入院期间血生化、凝血功能及血糖的变化进行分析,并就新生儿ABO溶血病对器官功能的影响进行评价。方法：选取2013年2月至2016年4月期间昆明医科大学第二附属医院儿科新生儿病区收治的确诊新生儿ABO溶血病196例,分为小于胎龄组(SGA组,n=29),适于胎龄组(AGA组,n=132),大于胎龄组(LGA组,n=35)；并随机选取同期住院无黄疸的处于疾病恢复期足月新生儿为对照组(n=75),所有观察组的新生儿均在入院后立即检测血生化、凝血功能及血糖,并对这些指标的变化进行统计学分析。结果：1.肝功能(1)SGA组、AGA组、LGA组和对照组ALT值分别为(19.54±3.88 U/L)、(20.29±3.70 U/L)、(16.54±3.50 U/L)、(13.45±1.48 U/L),SGA组和AGA组ALT测定值均高于对照组,差异具有统计学意义(P0.05),其余两两组比较无差异(P0.05)。(2)SGA组、AGA组、LGA组和对照组AST测定值分别为(63.24±10.68 U/L)、(59.02±3.53 U/L)、(53.79±±8.12 U/L)、(41.36±3.88 U/L),三个研究组AST值较对照组升高,差异有统计学意义(P0.05),其余两两组比较无统计学意义(P0.05)。2.肾功能SGA组、AGA组、LGA组和对照组血清BUN和CREA测定值分别为(3.20±0.85mmol/l；56.20±7.76 u mol/l)、(3.43±0.33 mmol/l；55.89±6.07umol/l)、(3.04±0.65 mmol/1;50.75±7.69μmol/1)、(2.94±0.32 mmol/l；51.58±5.33μmol/1),进行两两组比较,差异无统计学意义(P0.05)。3.心肌酶SGA组、AGA组、LGA组和对照组CK-MB测定值分别为(53.48±11.59 U/L)、(42.83±3.96 U/L)、(39.08±6.67 U/L)、(28.69±4.38 U/L),三个观察组CK-MB值均高于对照组,差异具有统计学意义(P0.05),其余两两组比较无统计学意义(P0.05)。4.凝血功能(1)SGA组、AGA组、LGA组和对照组PT值分别为(18.86±2.85s)、(16.45±1.73s)、(17.14±2.65s)、(15.60±1.49s),SGA组和LGA组PT测定值均高于对照组,差异具有统计学意义(P0.05),其余两两组比较无差异(P0.05)。(2)SGA组、AGA组、LGA组和对照组APTT测定值分别为(54.70±7.62s)、(42.35±3.18s)、(42.13±4.73s)、(38.56±2.02s),三个观察组APTT值均较对照组升高,差异具有统计学意义(P0.05)；SGA组APTT值高于AGA组、LGA组,差异有统计学意义(P0.05)；其余两两组比较无差异(P0.05)。(3)SGA组、AGA组、LGA组和对照组FIB值分别为(2.80±0.35 g/1)、(2.85±0.21 g/1)、(3.01±0.39 g/1)、(2.87±0.20 g/1),进行两两组比较,差异无统计学意义(P0.05)。(4)SGA组、AGA组、LGA组和对照组TT测定值分别为(18.07±3.80s)、(16.73±2.69s)、(16.47±1.26s)、(15.89±2.57s),SGA组TT测定值较对照组增高,差异有统计学意义(P0.05),其余两两组比较无差异(P0.05)。5.血糖SGA组、AGA组、LGA组发生低血糖率分别为3.44%、3.78%、0.00%,所有研究组低血糖发生率3.06%。这三个观察组发生低血糖情况比较无统计学意义(P0.05)。结论：1.新生儿ABO溶血病可能引起肝功、肾功、心肌酶、凝血功能和糖代谢的异常。2.不同胎龄别体重新生儿ABO溶血病对器官功能的影响之间无明显相关性。
[Abstract]:Objective: to retrospectively analyze 196 cases of ABO hemolytic disease of newborns of different gestational age, and analyze the changes of blood biochemistry, coagulation function and blood glucose during admission. The effects of neonatal ABO hemolytic disease on organ function were evaluated. Methods: from February 2013 to April 2016, 196 cases of neonatal ABO hemolytic disease were selected and treated in pediatric neonatal ward of the second affiliated Hospital of Kunming Medical University. It was divided into small gestational age group and SGA group, suitable for gestational age group and AGA group, and larger than LGA group for gestational age group, and randomly selected term neonates without jaundice in the same period as control group. All the newborns in observation group were all admitted to hospital. Immediately test blood biochemistry, The changes of blood coagulation function and blood glucose were analyzed statistically. Results: the ALT values of AGA group and control group were 19.54 卤3.88 U / L, 20.29 卤3.70 U / L, 16.54 卤3.50 UL / L, 13.45 卤1.48 UL / L SGA and 1.48 UL / L AGA, respectively, which were significantly higher than those in control group. The difference was statistically significant (P 0.05). The AST of the other two groups were 63.24 卤10.68 U / L and 59.02 卤3.53 U / L / L respectively. The AST values of the three study groups were 41.36 卤3.88 U / L / L ~ (-1) and 41.36 卤3.88 U / L / L ~ (-1), respectively. The serum BUN and CREA in the renal function SGA group and the control group were 3.20 卤0.85 mmol / L 56.20 卤7.76 mmol / L respectively (3.43 卤0.33 mmol / L = 55.89 卤6.07 mmol / L) 3.04 卤0.65 mmol / 1 卤7.69 渭 mol / L / L respectively. There was no significant difference in CK-MB between SGA group and control group (P < 0.05). The CK-MB values were 53.48 卤11.59 U / L, 42.83 卤3.96 U / L, 39.08 卤6.67 U / L and 28.69 卤4.38 U / L, respectively. The CK-MB values of the three observation groups were higher than those of the control group. The difference was statistically significant (P 0.05), but there was no significant difference between the other two groups. The PT values of LGA group and control group were higher than those of control group. The PT values in SGA group and LGA group were higher than those in control group. The PT values in SGA group and LGA group were higher than those in control group. The PT values in SGA group and LGA group were higher than those in control group. The PT values in SGA group and LGA group were significantly higher than those in control group (P < 0.05), and the PT values in SGA group and LGA group were significantly higher than those in control group. There was no significant difference between the other two groups (P 0.05, P 0.05, P 0.05, P 0.05), and the APTT values of the control group and the control group were 42.35 卤3.18 s and 42.13 卤4.73 sl, respectively. The APTT values of the three observation groups were higher than those of the control group, and the APTT values of the three observation groups were significantly higher than those of the AGA group. There was no significant difference between the other two groups in the FIB values of the AGA group and the control group were 2.80 卤0.35 g / L and 2.85 卤0.21 g / 1 / 1 respectively, and the FIB values of the two groups were 3.01 卤0.39 g / 1 2.87 卤0.20 g / 1, respectively. There was no significant difference in TT between LGA group and control group in AGA group and control group. The TT of SGA group was higher than that of control group. The TT of SGA group was higher than that of control group (P < 0.05). The TT of SGA group was higher than that of control group (P < 0.05), the TT of LGA group and control group were 16.73 卤2.69 sl, respectively, and the TT of SGA group was higher than that of control group. The hypoglycemia rate in SGA group was 3.44 and 3.780.000.The incidence of hypoglycemia in all study groups was 3.060.There was no significant difference between the other two groups. There was no significant difference in hypoglycemia among the three observation groups. Conclusion: 1. Neonatal ABO hemolytic disease may cause liver function, Abnormal renal function, myocardial enzymes, coagulation function and glucose metabolism. There was no significant correlation between ABO hemolytic disease and organ function in neonates with different gestational weight.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R722.18

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