摘要
目的分析足月新生儿ABO血型不合溶血病（简称ABO溶血病）伴高胆红素血症的临床表现、实验室检查结果、治疗措施和近期预后特点,为合理管理本病提供指导。方法选择2012年1月至2014年12月,在四川大学华西第二医院新生儿科住院治疗,并经实验室检查确诊为新生儿ABO溶血病伴新生儿高胆红素血症的331例足月新生儿为研究对象。回顾性分析患儿病历资料,包括临床表现、实验室检查结果、治疗措施及近期预后等。本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准,并与受试对象监护人签署临床研究知情同意书。结果本组331例新生儿ABO溶血病伴新生儿高胆红素血症的足月新生儿,其入院平均年龄为（53.5±36.2）h,48.0%（159/331）为男性患儿,45.0%（149/331）患儿胎次为1,剖宫产占59.2%（196/331）,混合喂养占71.6%（237/331）;发现黄疸时间平均为生后（29.7±19.4）h。入院时血清总胆红素（TSB）浓度平均为（233.1±90.0）μmol/L,9.4%（31/331）患儿TSB浓度〉342.0μmol/L,最高为614.7μmol/L;14.5%（48/331）患儿入院时伴贫血;A型血患儿占56.8%（188/331）;抗体释放试验阳性率显著高于直接抗人球蛋白试验（DAT）阳性率（95.5%vs 29.0%）,且差异有统计学意义（χ^2=311.076,P=0.000）。本组患儿光疗时间平均为（80.1±20.9）h,8.8%（29/331）患儿接受换血治疗及输血治疗,19.0%（63/331）患儿输注白蛋白,26.0%（86/331）患儿输注静脉免疫球蛋白。0.9%（3/331）患儿临床诊断新生儿胆红素脑病,平均住院时间为（4.7±1.8）d,1.8%（6/331）患儿在出院后4d内因黄疸原因再次入院。结论足月新生儿ABO溶血病伴高胆红素血症,可能发生贫血及严重高胆红素血症,甚至导致新生儿胆红素脑病。抗体释放试验可作为常规实验室检查以提高新生儿ABO溶血病诊断率。黄疸可能会持续�
Objective To analyze characteristics of clinical manifestations, laboratory test results, therapeutic measurements and early prognosis of neonatal ABO incompatibility hemolytic disease （simply as ＂ABO hemolytic disease＂） with hyperbilirubinemia in full-term infants,and provid directions of reasonable management of this disease. Methods A total of 331 cases of full-term infants who were confirmed neonatal ABO hemolytic disease with hyperbilirubinemia by laboratory tests, and hospitalized in department of neonatology,West China Second University Hospital, Sichuan University from January 2012 to December 2014 were chosen as study objects. Clinical manifestations, laboratory test results, therapeutic measurements and early prognosis of medical history of these 331 cases were analyzed,retrospectively. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital,Sichuan University. Informed consent was obtained from the parents of each participant. Results The admission mean age was （53.5----＋-36.2） h of these 331 cases of full-term neonatal ABO hemolytic disease with hyperbilirubinemia,48.0 % （159/331） patients were boys, 45.0 % （ 149/331 ） patients were born from the first pregnancy, 59.2 % （196/331） patients were cesarean delivery, 71.6 % （237/331） patients were mixed feeding,the mean jaundice noticed time was （29.7 ±19.4） h after born. The admission mean total serum bilirubin （TSB） was （233. 1±90.9）mol/L, the TSB concentration of 9.4% （31/331） patients were〉342.0 ILmol/L, the highest was 614.7μmol/L, 14.5 % （48/331） patients were admitted to hospital with anemia, 56.8%（188/331） patients with type A blood,the rate of eluate positive for anti-A/B test was higher than that of direct antiglobulin test（DAT）（95. 5% vs 29. 0%）, and the difference was statistically significant（y2 = 311. 076, P= 0. 000）. Mean phototherapy time was （80.1 4- 20.9） h,8.8% （29/331） patients accep
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2016年第2期154-158,共5页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
国家自然科学基金项目(81370738)~~
关键词
ABO血型系统
血型不合
高胆红素血症
光疗法
换血疗法
全血
核黄疸
婴儿
新生
ABO blood-group system
Blood group incompatibility
Hyperbilirubinemia
Phototherapy
Exchange transfusion,whole blood
Kernicterus
Infant,newborn
