發(fā)布時間：2019-06-21 03:47

【摘要】：目的 分析O型血孕婦的妊娠胎次對新生兒ABO溶血�。ˋBO hemolyticdisease of newborn,ABO-HDN）病情嚴重程度的影響；并探討ABO-HDN的血型分布情況及患兒血型（A型或型）與ABO-HND病情輕重的關(guān)系。 方法 收集2012年9月15日至2013年2月28日重慶醫(yī)科大學附屬兒童醫(yī)院新生兒診治中心收治的符合入選標準的ABO-HDN193例，，對這些病例的臨床資料進行回顧性分析：首先根據(jù)母親是否首次妊娠分成首次妊娠組和非首次妊娠組，首次妊娠組82例，非首次妊娠組111例，比較兩組新生兒生后初次出現(xiàn)黃疸的時間、入院時血清總膽紅素、白蛋白、達到換血標準的比例、血紅蛋白、貧血發(fā)生比例、光療時間、住院天數(shù)，并比較兩組患兒改良直接抗人球蛋白試驗（即改良Coombs試驗）、抗體釋放試驗、游離抗體試驗結(jié)果。其次根據(jù)患兒ABO血型分為A型血組和B型血組，A型血組為114例，B型血組為79例，同樣比較兩組新生兒生后初次出現(xiàn)黃疸的時間、入院時血清總膽紅素、白蛋白、達到換血標準的比例、血紅蛋白、貧血發(fā)生比例、光療時間、住院天數(shù)，并比較兩組患兒改良Coombs試驗、抗體釋放試驗、游離抗體試驗結(jié)果。 結(jié)果 ⑴首次妊娠組與非首次妊娠組的生后初次出現(xiàn)黃疸的時間、入院時血清總膽紅素、血紅蛋白、白蛋白、光療時間、住院天數(shù)分別為：(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，兩組比較均無統(tǒng)計學的差異（P0.05）。兩組患兒貧血發(fā)生比例、達到換血標準的比例及改良Coombs試驗、抗體釋放試驗、游離抗體試驗結(jié)果相比較其差異均無顯著性（P0.05）。 ⑵A型血的患兒多于B型血，兩組患兒生后初次出現(xiàn)黃疸的時間、入院時血清總膽紅素、血紅蛋白、白蛋白、光療時間、住院天數(shù)分別為：（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，兩組比較均無顯著統(tǒng)計學差異（P0.05）。兩組患兒貧血發(fā)生比例、達到換血標準的比例、改良Coombs試驗、抗體釋放試驗、游離抗體試驗結(jié)果相比較均無顯著統(tǒng)計學差異（P0.05）。 結(jié)論 O型血母親的母親的妊娠胎次及患兒的血型（A型血或B型血）與ABO溶血病的新生兒在首次出現(xiàn)黃疸的時間、入院時血清總膽紅素、白蛋白、達到換血標準的比例、血紅蛋白、貧血發(fā)生比例、光療時間、住院天數(shù)無明顯相關(guān)性；與改良Coomb試驗、抗體釋放試驗、游離抗體試驗結(jié)果也無明顯相關(guān)性。所以對患有ABO溶血病的新生兒無論母親是否首次妊娠、無論患兒是A型血還是B型血，都應該引起臨床醫(yī)生足夠的重視，做到早診斷、早治療，減少膽紅素腦病、神經(jīng)系統(tǒng)后遺癥、死亡的發(fā)生。本文資料中A型血患兒比B型血多，可能本地區(qū)人群血型基因分布有關(guān)。
[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 鹵28.08) vs (40.52 鹵29.07) h, (288.86 鹵93.20) vs (309.84 鹵104.34) 渭 mol/L, (147.73 鹵21.91) vs (149.14 鹵22.37) g / L, respectively. (35.67 鹵4.07) vs (35.79 鹵3.67) g 鈮

本文編號：2503762