Mur血型不合导致新生儿溶血病1例报告并文献复习

Hemolytic disease caused by Mur blood type incompatibility in one neonate and literatures review

目的总结1例Mur血型不合导致新生儿溶血病的临床特点及其治疗情况,并进行文献复习。方法对东南大学医学院附属盐城医院2012年5月收治的1例母子Mur血型不合导致的新生儿溶血病进行分析,对其临床症状、体征、实验室检查结果以及治疗进行分析总结。结果患儿为一5d新生儿,生后2d皮肤黄疸,入院前予以蓝光治疗2次,黄疸仍反复,体格检查可见轻度贫血貌,皮肤中重度黄染,血常规血红蛋白116g/L,肝功能总胆红素371.2μmol/L,直接胆红素30.6μmol/L。溶血三项:直接抗人球蛋白试验阳性、游离抗体试验阴性、放散实验阳性。母亲血清学检出抗-Mur抗体,患儿Mur抗原阳性。结论母婴Mur血型不合可以导致严重的溶血,对排除ABO、Rh血型不合的溶血病的患儿,应考虑Mur血型不合导致的溶血病可能。

Objective To summarize the clinical features of a neonate with hemolytic disease caused by Mur blood type incompatibility and make literature review.Methods To summarize and analyze the clinical data and laboratory test results of a neonate who was admitted to the Yancheng Hospital Affiliated to Southeast University Medical College with hemolytic disease caused by Mur blood type incompatibility.Results A 5-day old neonate had skin jaundice at 2 days after birth.After two times of treatment with blue light before admission to the hospital,the jaundice still existed.The physical examination showed appearance of mild anemia and moderate to severe jaundice of skin.The routine blood test showed that hemoglobin was 116 g/L,and live function test revealed that total bilirubin was 371.2μmol/L and direct bilirubin was 30.6μmol/L.The three-item detection of hemolysis showed that direct Coombs test was positive,free antibody test was negative and elution test was positive.Anti-Mur antibody was detected in mother's serum,and the Mur antigen of the neonate was positive.Conclusion Mur blood type incompatibility of mother and neonate can result in serious hemolysis.For the children with hemolysis without ABO or Rh blood type incompatibility,the Mur incompatibility should be considered as the cause of the disease.