新生儿ABO溶血病并红细胞葡萄糖-6-磷酸脱氢酶缺乏症临床对比分析

Clinical analysis of ABO hemolytic disease in newborn with giucose-6-phosphate dehydrogenase deficiency.

目的 探讨新生儿ABO溶血病、红细胞葡萄糖-6-磷酸脱氢酶（G-6-PD）缺乏症及两者合并患儿的临床特点.方法 对160例新生儿ABO溶血病（ABO组）、219例G-6-PD缺乏症（G6PD组）、52例新生儿ABO溶血病并G-6-PD缺乏症（ABO＋G617D组）3组临床相关指标进行对比分析.结果 G6PD组血红蛋白[（159.7±24.9）g/L]高于ABO组[（150.2±23.0）g/L]和ABO＋G6PD组[（149.2±22.8）g/L],差异均有统计学意义（P均〈0.01）;血清总胆红紊高于ABO组[（419.0±152.9）μmol/L与（355.4±113.2）μmol/L],差异有统计学意义（P〈0.01）;黄疸消退时间较ABO组长[（9.4±2.3）d与（8.1±2.2）d],差异有统计学意义（P〈0.01）.ABO＋G6PD组黄疸消退时间[（12.0±2.7）d]、光疗时间[（43.2±16.0）h]、光疗次数[（3.5±1.2）次]均长或多于ABO组[（8.1.4-2.2）d、（36.1 4-15.9）h、（2.6±1.2）次]及其G6PD组[（9.4±2.3）d、（37.6±17.3）h、（2.8 4-1.3）次],差异均有统计学意义（P均〈0.05）.G6PD组胆红素脑病（16.O%）、低钙血症发生率（32.9%）高于ABO组（6.9%、20.0%）,差异有统计学意义（P〈0.05）;而其贫血发生率（23.3%）则低于ABO组（40.0%）及其ABO＋G6PD组（51.9%）,差异有统计学意义（P〈0.01）.结论 新生儿ABO溶血病并G-6-PD缺乏症时,黄疸出现时间、黄疸程度、胆红素脑病发生率与新生儿ABO溶血病、G-6-PD缺乏症差异无显著性,但黄疸消退时间更长,黄疸更易反复.G-6-PD缺乏症与新生儿ABO溶血痛相比,黄疸程度更重,退黄时间更长,更易发生胆红素脑病,但贫血发生率更低.

Objective To explore the clinical features of ABO hemolytic disease in newboms,red blood cell glucose-6-phosphate dehydrogenase（G-6-PD） deficiency and the combined. Methods In the study, 160 cases of ABO hemolytic disease in newborn （ABO group） ,219 cases of G-6-PD deficiency（G6PD group） ,52 cases of the combined（ABO ＋ G6PD group）. The three groups were analyzed. Results The hemoglobin in the G6PD group （ （159. 7 ± 24.9） g/L） was significantly higher than in the ABO group （（150. 2 ± 23.0） g/L） and ABO ＋ G6PD group（ （149. 2 ±22. 8） g/L） （P 〈 0. 01）. TBIL in the G6PD group （ （419. 0 ± 152. 9）μmol/L） was significantly higher than that in the ABO group （ （ 355. 4 ± 113. 2 ）μmol/L） （ P 〈 0. 01）. The Jaundice dissipated time in the G6PD group were significantly longer than ABO group （ （ 9.4 ± 2. 3） d vs. （ 8. 2 ± 2. 2 ） d） （ P 〈 0. 01 ） . In the ABO ＋ G6PD group, the Jaundice dissipated time, time of phototherapy and number of phototherapy was （12. 0 ± 2. 7）d,（43. 2±16. 0）h and （3.5 ± 1. 2） times, which was significantly longer （or more） than those of the ABO group （（8. 1 ±2.2）d,（36. 1 ±15.9）h and （2. 6 ±1. 2）times） and G6PD group（ （9.4 ±2. 3）d,（37. 6 ± 17. 3）h and （2. 8 ± 1. 3） times） （P〈0. 05）. The incidence of the bilirubin encephalopathy, hypocalcemia rate in the G6PD group （16. 0% ,32.9% ） were significantly higher than those in the ABO group（6. 9% and 20.0% ） （P 〈0. 05 ） . However, the incidence of anemia （23. 3% ） in the G6PD group was significantly lower than that in the ABO group （40. 0% ） and ABO ＋ G6PD group （51.9%） （ P 〈 0. 01） . Conclusions In the newborns with ABO hemolytic disease and G-6-PD deficiency,the time jaundice appear,the degree of jaundice,bilirubin encephalopathy rate were not significantly different from those in the ABO hemolytic disease and G-6-PD group, but the jaundice persisted longer,and more easily repeated. Compared to the neonatal ABO hemolytic disease, the degree of jaundice, jaundice persisted longer in the G-6-PD deficiency,bilirubin encephalopathy is more likely to occur,whereas the incidence of anemia is much lower.