ABO溶血病与G6PD缺乏症致足月新生儿高胆红素血症临床特点比较

Clinical characteristics of hyperbilirubinemia caused by ABO hemolytic disease and G6PD deficiency in full-term newborns

目的比较ABO溶血病与红细胞葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症致足月新生儿高胆红素血症的临床特点。方法对2013年3月至2015年2月入住海南省妇幼保健院新生儿科的104例足月新生儿ABO溶血病(ABO组)与51例G6PD缺乏症(G6PD组)所致高胆红素血症的临床特点进行病例对照分析。结果 72 h内ABO组97例(93.27%),G6PD组47例(92.16%)出现黄疸并达峰值;ABO组黄疸出现时间为(1.28±0.78)d,明显短于G6PD组的(1.83±1.01)d,差异具有统计学意义(P<0.05);ABO组与G6PD组血清总胆红素峰值分别为(326.54±91.05)μmol/L和(360.23±128.34)μmol/L,两组比较差异无统计学意义(P>0.05);ABO组与G6PD组黄疸平均消退时间分别为(5.58±1.24)d和(5.94±1.65)d,两组比较差异无统计学意义(P>0.05)。两组共3例存在急性胆红素脑病表现,其中ABO组2例,G6PD组1例。结论 ABO溶血病与G6PD缺乏症是足月新生儿早期高胆的常见原因;新生儿ABO溶血病较G6PD缺乏症所致新生儿黄疸发生时间早,黄疸程度及消退时间等差异无统计学意义。

Objective To investigate the clinical characteristics of hyperbilirubinemia induced by ABO hemolytic disease and erythrocyte glucose-6-phosphate dehydrogenase(G6PD) deficiency in full-term newborns. Methods From Mar. 2013 to Feb. 2015, 104 full-term newborns with hyperbilirubinemia induced by ABO hemolytic disease(ABO group) and 51 newborns with hyperbilirubinemia caused by G6 PD deficiency(G6PD group) in our hospital were enrolled in the study. The clinical characteristics of hyperbilirubinemia were analyzed and compared between the two groups. Results In two groups, jaundice appeared mostly within 72 hours [97 cases(93.27%) in ABO group vs 47 cases(92.16%) in G6 PD group] and reached the peak value. The occurrence time of jaundice in ABO group was significantly earlier than that in G6 PD group [(1.28±0.78) d vs(1.83±1.01) d, P<0.05]. The peak value of serum total bilirubin was(326.54±91.05) μmol/L in ABO group and(360.23±128.34) μmol/L in G6 PD group, with no statistically significant difference between the two groups(P>0.05). Jaundice subsided time was(5.58±1.24) d in ABO group and(5.94±1.65) d in G6 PD group, with no statistically significant difference between the two groups(P>0.05). Totally 3 cases of acute bilirubin encephalopathy occurred in the two groups, among which 2 cases were from ABO group and 1 case was from G6 PD group. Conclusion ABO hemolytic disease and G6 PD deficiency are the common causes of hyperbilirubinemia in full-term neonates. The occurrence time of jaundice caused by ABO hemolytic is earlier than that of G6 PD deficiency,but there is no significant difference in the degree and the subsided time of jaundice.