193例新生儿ABO溶血病临床资料分析

发布时间：2019-06-21 03:47

【摘要】：目的 分析O型血孕妇的妊娠胎次对新生儿ABO溶血病（ABO hemolyticdisease of newborn,ABO-HDN）病情严重程度的影响；并探讨ABO-HDN的血型分布情况及患儿血型（A型或型）与ABO-HND病情轻重的关系。 方法 收集2012年9月15日至2013年2月28日重庆医科大学附属儿童医院新生儿诊治中心收治的符合入选标准的ABO-HDN193例，，对这些病例的临床资料进行回顾性分析：首先根据母亲是否首次妊娠分成首次妊娠组和非首次妊娠组，首次妊娠组82例，非首次妊娠组111例，比较两组新生儿生后初次出现黄疸的时间、入院时血清总胆红素、白蛋白、达到换血标准的比例、血红蛋白、贫血发生比例、光疗时间、住院天数，并比较两组患儿改良直接抗人球蛋白试验（即改良Coombs试验）、抗体释放试验、游离抗体试验结果。其次根据患儿ABO血型分为A型血组和B型血组，A型血组为114例，B型血组为79例，同样比较两组新生儿生后初次出现黄疸的时间、入院时血清总胆红素、白蛋白、达到换血标准的比例、血红蛋白、贫血发生比例、光疗时间、住院天数，并比较两组患儿改良Coombs试验、抗体释放试验、游离抗体试验结果。 结果 ⑴首次妊娠组与非首次妊娠组的生后初次出现黄疸的时间、入院时血清总胆红素、血红蛋白、白蛋白、光疗时间、住院天数分别为：(38.59±28.08) vs (40.52±29.07)h、(288.86±93.20) vs (309.84±104.34)μmol/L、（147.73±21.91) vs （149.14±22.37）g/L、（35.67±4.07）vs（35.79±3.67）g/L、(67.35±29.92)vs(68.83±26.83)h、(7.59±1.35)vs(7.72±1.48)天，两组比较均无统计学的差异（P0.05）。两组患儿贫血发生比例、达到换血标准的比例及改良Coombs试验、抗体释放试验、游离抗体试验结果相比较其差异均无显著性（P0.05）。 ⑵A型血的患儿多于B型血，两组患儿生后初次出现黄疸的时间、入院时血清总胆红素、血红蛋白、白蛋白、光疗时间、住院天数分别为：（41.56±26.70）vs （37.03±31.12）h、（297.23±102.34）vs（306.25）±（97.05）μmol/L、（150.18±21.40） vs(145.82±22.94）g/L、（35.96±3.86）vs (35.427±3.81)g/L、(67.04±28.54) vs (69.87±27.59)、(7.61±1.41)vs(7.73±1.46)天，两组比较均无显著统计学差异（P0.05）。两组患儿贫血发生比例、达到换血标准的比例、改良Coombs试验、抗体释放试验、游离抗体试验结果相比较均无显著统计学差异（P0.05）。 结论 O型血母亲的母亲的妊娠胎次及患儿的血型（A型血或B型血）与ABO溶血病的新生儿在首次出现黄疸的时间、入院时血清总胆红素、白蛋白、达到换血标准的比例、血红蛋白、贫血发生比例、光疗时间、住院天数无明显相关性；与改良Coomb试验、抗体释放试验、游离抗体试验结果也无明显相关性。所以对患有ABO溶血病的新生儿无论母亲是否首次妊娠、无论患儿是A型血还是B型血，都应该引起临床医生足够的重视，做到早诊断、早治疗，减少胆红素脑病、神经系统后遗症、死亡的发生。本文资料中A型血患儿比B型血多，可能本地区人群血型基因分布有关。
[Abstract]:Objective to analyze the effect of pregnancy order of pregnant women with type O blood on the severity of neonatal ABO hemolytic disease (ABO hemolyticdisease of newborn,ABO-HDN), and to explore the blood group distribution of ABO-HDN and the relationship between blood group (type A or type A) and the severity of ABO-HND. Methods from September 15, 2012 to February 28, 2013, ABO-HDN193 cases were collected from the Neonatal diagnosis and treatment Center of affiliated Children's Hospital of Chongqing Medical University. The clinical data of these cases were analyzed retrospectively. firstly, according to whether the mother first pregnancy or not, 82 cases in the first pregnancy group and 111 cases in the non-first pregnancy group, the first pregnancy group and the non-first pregnancy group were divided into first pregnancy group and non-first pregnancy group according to whether the mother was pregnant for the first time or not. The time of jaundice after birth, the proportion of serum total bilirubin and albumin, the proportion of hemoglobin and anemia, the time of phototherapy and the days of hospitalization were compared between the two groups, and the results of modified direct antiglobulin test (modified Coombs test), antibody release test and free antibody test were compared between the two groups. Secondly, according to the ABO blood group, the children were divided into type A blood group and type B blood group, type A blood group (n = 114) and type B blood group (n = 79). The time of first jaundice after birth, the proportion of serum total bilirubin and albumin, the proportion of hemoglobin, anemia, phototherapy time and hospitalization days between the two groups were compared, and the modified Coombs test and antibody release test were compared between the two groups. The results of free antibody test. Results 1the time of jaundice in the first pregnancy group and the non-first pregnancy group, the time of serum total bilirubin, hemoglobin, albumin and phototherapy on admission were (38.59 卤28.08) vs (40.52 卤29.07) h, (288.86 卤93.20) vs (309.84 卤104.34) 渭 mol/L, (147.73 卤21.91) vs (149.14 卤22.37) g / L, respectively. (35.67 卤4.07) vs (35.79 卤3.67) g 鈮

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