282例新生儿溶血症临床分析

THE ANALYSIS OF HEMOLYTIC DISEASE OF NEWBORNS IN 282 CASES

本文按照新生儿溶血症(Hemolytic Disease of Newborn)HDN中,三项试验诊断标准,十年中共检出新生儿溶血症282例。男性156例,占55.31％,女性126例,占44.68％。年龄在出生后9小时至12天。在282例新生儿溶血症,抗体依次为抗A 124例(44％)、抗B 97例(34％)、抗D 45例(16％)、抗E 9例(3％)、抗cE 5例(2％)、抗Ce及抗C各1例。所占比例分别为:43.97％、34.39％、15.9％、3.19％、1.77％、0.71％。直接抗人球蛋白试验阳性115例占40.78％,释放试验阳性265例,占94.15％。游离试验阳性249例,占88.3％。结果提示,除ABO以外,Rh血型系统是引起上海地区HDN的主要血型抗体。对高危孕妇进行血清学检测来预报HDN,以便做到早发现、早治疗。

In the past ten years, the fetus blood samples from 282 newborns were analyzed according to the three standard tests of hemolytic disase of nowborn HDN, using ABO and Rh antigen which were grouped by tube test, while direct antiglobulin test (DAT), indirect antiglobulin test (IAT) and elution test were also be performed. Among 282 newborns, 156(55.31%) were male and 126(44.68%) were female. The age of these newborn were between 9 hr to 12 days. Antibodies in these 282 HDN: Anti-A 124 cases (43.97%); Anti-B97 cases(34.39%); Anti-D 45(15.95%); Anti-E 9 cases(3.19%); Anti-cE 5 cases(1.77%); Anti-Ce 1 cases(0.71%) and Anti-C 1 cases(0.71%). DAT positive cases were 115 (40.78%) and DAT negative cases were 167 (59.21%). 265 cases were elution test positive(93. 97%), 249 cases were IAT positive(88.29%). So Rh antibodies are the majority antibodies causing HDN in Shanghai region except ABO system. It is improtant to identified ABO and Rh blood group during 3-4 month of pregnant for the secondary pregnancy or a women who have a history of abortion or premature birth. And it is also important to detect the antibody in serum for incompatible blood group pregnancy to find the HDN early.