新生儿ABO溶血病与ABO血型的关系

Relationship between neonatal ABO hemolytic disease and ABO blood type

目的探讨新生儿ABO溶血病与新生儿ABO血型的关系。方法选取该院2015年1月至2016年1月符合筛选标准的64例ABO新生儿溶血病筛查（包括直接抗人球蛋白试验,即Coombs试验、游离试验及放散试验）结果为阳性患儿作为研究对象,对其中A、B型患儿的患病情况进行比较分析。结果 64例新生儿ABO溶血病患儿中,A型Rh（D）患儿阳性率[60.9%（39/64）]显著高于B型Rh（D）阳性患儿[39.1%（25/64）],差异有统计学意义（P〈0.05）。当Coombs试验阳性强度为1＋时,A型患儿阳性率与B型患儿阳性率比较,差异无统计学意义（P〉0.05）;当阳性强度为2＋时,A型患儿阳性率[25.6%（10/39）]显著高于B型患儿[12.0%（3/25）],差异有统计学意义（P〈0.05）。当游离试验阳性强度为1＋时,A型患儿阳性率[25.6%（10/39）]低于B型患儿[44.0%（11/25）];而当阳性强度为2＋~3＋时,A型患儿阳性率[61.5%（24/39）]高于B型患儿[32.0%（8/25）],差异均有统计学意义（P〈0.05）。当放散试验阳性强度为1＋时,A型患儿阳性率[17.9%（7/39）]显著低于B型患儿[48.0%（12/25）];而当阳性强度为3＋~4＋时,A型患儿阳性率[41.0%（16/39）]高于B型患儿[16.0%（4/25）],差异均有统计学意义（P〈0.05）。结论在ABO血型不合引起的新生儿溶血病中,A型患儿的患病概率高于B型患儿,其病情常重于B型患儿,且病情的进展情况也可能高于B型患儿。

Objective To investigate the relationship between neonatal ABO hemolytic disease and ABO blood type.Methods Sixty-four neonatal patients with positive results of the direct antiglobulin test（Coombs test）,free test and elution test and meeting the screening standard in our hospital from January 2015 to January 2016 were selected as the research subjects. Among them,the prevalence situation was analyzed and compared between neonatal patients with blood type A and blood type B. Results In 64 cases of neonatal ABO hemolytic disease,the positive rate of type A Rh（D） was 60.9%（39/64）,which was significantly higher than 39.1%（25/64） of type B Rh（D）,the difference was statistically significant（P〈0.05）. When the intensity of the Coombs test positive was 1＋,the difference in the positive rate between the type A and type B had no statistical significance（P〉0.05）;when the positive intensity was 2＋,the positive rate of type A was 25.6%（10/39）,which was significantly higher than 12.0%（3/25） of type B,the difference was statistical significant（P〈0.05）. When the positive intensity in the free test reached 1＋,the positive rate of type A was 25.6%（10/39）,which was lower than 44.0%（11/25） of type B;when the positive intensity was 2 ＋~3 ＋,the positive rate of type A was 61.5%（24/39）,which was higher than 32.0%（8/25） of type B,the difference was statistically significant（P〈0.05）. The intensity of elution test positive was 1＋,the positive rate of type A was 17.9%（7/39）,which was significant lower than48.0%（12/25） of type B;when the positive intensity was 3＋~4＋,the positive rate of type A was 41.0%（16/39）,which was higher than 16.0%（4/25）,the difference was statistically significant（P〈0.05）. Conclusion In neonatal hemolytic disease caused by ABO blood type incompatibility,the prevalence rate of type A neonatal patients is higher than that of type B neonatal patients and the disease condition is usually severe than that of type B,moreover the probability of disease progression is also higher than that of type B neonatal patients.