R H是目前44个人类红细胞血型系统中除ABO血型外,最复杂、最富多态性的血型系统,D抗原是其中免疫原性最强的,红细胞上无D抗原为RHD阴性(简称RH-)血型。RH-人群的比例差异较大,欧美人群约占15-17%,非洲人群约占3-10%,我国及其他东南亚人...R H是目前44个人类红细胞血型系统中除ABO血型外,最复杂、最富多态性的血型系统,D抗原是其中免疫原性最强的,红细胞上无D抗原为RHD阴性(简称RH-)血型。RH-人群的比例差异较大,欧美人群约占15-17%,非洲人群约占3-10%,我国及其他东南亚人群比例少约占0.3-0.4%。RH-在我国虽属稀有血型,但根据其人群的分布特点和遗传规律,我国的RH-孕妇分娩RH+胎儿的概率反而极高;且随着我国近年来多胎生育政策的逐步开放,RH-妇女再次妊娠率逐年增加,RH-血的用血需求也相应增加。上述情况增加了母婴RH血型不合的风险,进而增加了胎儿/新生儿免疫溶血性疾病 (简称HDFN)的风险,HDFN发病早、进展快、病情严重、并发症风险高,严重威胁围产儿的生命健康、影响患儿远期生活质量,因此规范RH-孕产妇的围孕期管理尤为重要。但目前我国尚无统一、权威的管理指南,故本文综合了国内外相关文献,总结了围产保健方向的RH-孕产妇的围孕期管理规范要点,供临床产科医生参考,以降低HDFN发生率、围产儿死亡率、提高母婴保健质量。展开更多
The screening practices for hepatitis D virus(HDV)are diverse and nonstandardized worldwide,and the exact prevalence of HDV is uncertain.AIM To estimate HDV prevalence and investigate viral marker quantity trends in p...The screening practices for hepatitis D virus(HDV)are diverse and nonstandardized worldwide,and the exact prevalence of HDV is uncertain.AIM To estimate HDV prevalence and investigate viral marker quantity trends in patients with hepatitis D.METHODS We collected 5594 serum samples from patients with hepatitis B in Jilin Province,China(3293 males and 2301 females,age range of 2 to 89 years).We then conducted tests for hepatitis B surface antigen(HBsAg),hepatitis B Virus(HBV)DNA,anti-hepatitis D antigen(HDAg),and HDV RNA.RESULTS We found that the prevalence of anti-HDAg and HDV RNA among hepatitis B patient were 3.6%(3.2-4.2%)and 1.2%(0.9-1.5%),respectively,87.69%of hepatitis D patients were 51-70 years old.HDV infection screening positive rate of patients with HBV DNA levels below 2000 IU/mL(2.0%)was higher than those above 2000 IU/mL(0.2%).Among anti-HDAg positive patients,the HDV RNA positive rate was positively correlated with the HBsAg level and anti-HDAg level.There was a weak correlation between HBsAg and anti-HDAg levels among hepatitis D patients.CONCLUSION Our study highlights the importance of considering multiple factors when assessing the severity of HDV infection,comprehensive evaluation of patients’clinical and laboratory parameters is necessary for proper diagnosis and treatment.展开更多
基金the National Natural Science Foundation of Jilin Provence,No.YDZJ202201ZTYS016and Jilin Provincial Health Commission,No.2022JC053.
文摘The screening practices for hepatitis D virus(HDV)are diverse and nonstandardized worldwide,and the exact prevalence of HDV is uncertain.AIM To estimate HDV prevalence and investigate viral marker quantity trends in patients with hepatitis D.METHODS We collected 5594 serum samples from patients with hepatitis B in Jilin Province,China(3293 males and 2301 females,age range of 2 to 89 years).We then conducted tests for hepatitis B surface antigen(HBsAg),hepatitis B Virus(HBV)DNA,anti-hepatitis D antigen(HDAg),and HDV RNA.RESULTS We found that the prevalence of anti-HDAg and HDV RNA among hepatitis B patient were 3.6%(3.2-4.2%)and 1.2%(0.9-1.5%),respectively,87.69%of hepatitis D patients were 51-70 years old.HDV infection screening positive rate of patients with HBV DNA levels below 2000 IU/mL(2.0%)was higher than those above 2000 IU/mL(0.2%).Among anti-HDAg positive patients,the HDV RNA positive rate was positively correlated with the HBsAg level and anti-HDAg level.There was a weak correlation between HBsAg and anti-HDAg levels among hepatitis D patients.CONCLUSION Our study highlights the importance of considering multiple factors when assessing the severity of HDV infection,comprehensive evaluation of patients’clinical and laboratory parameters is necessary for proper diagnosis and treatment.
