223例新生儿溶血病的回顾性研究

Hemolytic diseases of the newborn: Aretrospective study of 223 cases

目的回顾调查本院2016-2019年新生儿不规则抗体和ABO血型抗体导致新生儿溶血病的案例,了解红细胞不规则抗体与新生儿溶血病的相关性。方法抽取不规则抗体阳性病例122例,同时随机抽取单纯ABO血型不相合致新生儿溶血病的病例101例作为对照组,记录新生儿红细胞血型结果、不规则抗体筛查及鉴定结果、血清总胆红素值、血红蛋白值、出院诊断等信息。结果不规则抗体共10种类型包括抗-D占比83.6%(102/122)、抗-E占比6.56%(8/122)、抗-c+E占比2.46%(3/122)、抗-c占比1.64%(2/122)、抗-G占比1.64%(1/122)、抗-e占比0.82%(1/122)、抗-K占比0.82%(1/122)、抗-M占比0.28%(1/122)、抗-Jka占比0.28%(1/122)、抗-Fya占比0.28%(1/122)。ABO-HDN和不规则抗-HDN相比总胆红素(167.25±113.22,326.78±193.34)、血红蛋白(154.36±29.42,114.73±35.80)差异均有统计学意义(P<0.05);抗D-HDN与其他不规则抗体-HND相比总胆红素(340.14±189.11,241.80±162.52)、血红蛋白(113.33±33.53,130.60±37.29)也存在明显差异(P<0.05)。结论产前检测血型,不规则抗体并鉴定抗体特异性及性质,针对不规则抗体的特性进行合理的预防治疗,对于减少胎儿新生儿溶血病发病率具有极其重要的意义。

Objective To explore the correlation between irregular red blood cell antibodies and hemolytic disease of the newborn(NHD) byinvestigating NHD cases due to irregular antibodies and ABO blood group antibodies in our hospital from 2016 to 2019 retrospectively.Methods 122 NHD cases due to irregular antibodies were selected, and 101 NHD cases due to ABO blood group incompatibility were randomly selected as the control group.Neonatal blood group results, irregular antibody screening and identification results, serum total bilirubin value, hemoglobin value, discharge diagnosis and other information were recorded.Results There were 10 types of irregular antibodies, including anti-D accounted for 83.6%(102/122), anti-E 6.56%(8/122), anti-c+E 2.46%(3/122), anti-c1.64%(2/122), anti-G 1.64%, anti-e 0.82%(1/122), anti-K 0.82%(1/122), anti-M0.28%(1/122), anti-Jka0.28%(1/122), and anti-Fya0.28%(1/122). The total bilirubin(167.25±113.22 vs 326.78±193.34) and hemoglobin(154.36±29.42 vs 114.73±35.80) were statistically significant between irregular antibody-HDNand ABO-HDN(P<0.05);thetotal bilirubin(340.14±189.11 vs 241.80±162.52) and hemoglobin(113.33±33.53 vs 130.60±37.29)between anti-D-HDNandother irregular antibodyHDNshowed significant differences(P<0.05).Conclusion Theprenatal detection of blood type andirregular antibodies(specificity and property)for early prevention and treatment of HDNare conductive to reduce the incidence of HDN.