新生儿ABO溶血病56例临床分析

A clinical analysis of 56 cases of neonatal hemolytic disease due to ABO incompatibility

目的分析新生儿ABO溶血病的临床表现及血清学检查特点,以提高早期诊断水平。方法对本院56例新生儿ABO溶血病患儿的临床表现、诊断及预后进行回顾性分析。结果56例患儿之母均为O型血,子为A型血28例(50.0%),B型血28例(50.0%);生后36小时之内出现黄疸者40例(71.2%),多数黄疸程度较轻,但仍有11例(19.6%)为重度黄疸(血清胆红素超过342μmol/L);部分病例伴有贫血、惊厥等表现。三项血清学诊断试验中最有诊断意义的试验是抗体释放试验,阳性率高达100%;采用了蓝光照射加其它药物综合治疗,达到很好的效果。结论新生儿ABO溶血病以黄疸为突出症状,可伴有贫血等其他临床表现,综合治疗效果较好,抗体释放试验有助于早期诊断及减少误诊率。

Objective To analyze clinical manifestation and characteristics of serological examination of the newborn with ABO hemolytic disease, so as to improve early diagnosis of the disease. Methods Clinical manifestation, diagnosis and prognosis of 56 infants with ABO hemolytic disease were retrospectively analyzed. Results All mothers had blood type 0, 28 （50.0%） infants had blood type A （O-A）, and 28 remaining infants（50.0% ） had blood type B. Jaundice appeared within the first 36 hours after birth in 40 cases （71. 2%）, most of jaundice were not serious, but jaudice of 11 cases（ 19. 6 %） was severe （bilirubin concentration 342 mol/L）. Some cases were associated with anemia, convulsion. Antibody release test was of the most important significance in diagnosis of ABO hemolytic disease, the positive rate of which was 100%. The combined therapy with blue light and other drugs had better therapeutic effiect. Conclusion The main symptom of infants with ABO hemolytic disease is jaundice, while anemia may be an accompanying sign, antibody release test can be contributive to early diagnosis and decrease misdiagnosis rate.