BACKGROUND Anti-D antibody is not the common cause of Rh-isoimmunization in Chinese neonatal jaundice.Recent change in national population policy has followed by an increase in Rh-isoimmunization related hemolytic dis...BACKGROUND Anti-D antibody is not the common cause of Rh-isoimmunization in Chinese neonatal jaundice.Recent change in national population policy has followed by an increase in Rh-isoimmunization related hemolytic disease of the newborn(HDN).Unfortunately,regional status of Rh-HDN is unavailable.We hypothesize that Rh-HDN in our region is most commonly due to anti-E antibody.AIM To investigate the prevalence of hemolytic disease of the newborn due to Rhisoimmunization in Hefei City.METHODS Retrospective review of data obtained from Children’s Hospital of Anhui and Hefei Blood Center between January 2017 and June 2019.Status of minor blood group antibody was studied in the corresponding mothers.RESULTS Totally 4138 newborns with HDN admitted during the study period and 116(2.8%)received blood exchange transfusion(BET).Eighteen newborns(0.43%)with proven Rh-incompatible HDN were identified.All were not the first-born baby.Thirteen mothers were RhD(+)(72%)and five were RhD(-).The distribution of Rh-related antibodies in mothers was ten anti-E(55%),five anti-D(27%),and for one anti-C,anti-c,and anti-E/c(6%)each.Thirteen(72.2%)were qualified for BET,relative risk for BET was 28.9 as compared to other types of HDN,but only 10 received due to parenteral refusal.All(100%)RhD related HDN received BET which is not significantly different from RhE related HDN(81.8%).CONCLUSION As expected,all Rh-incompatible HDN newborns were not the first-born.Contrary to the Caucasian population,anti-D induced HDN is not the most common etiology.In our region,anti-E(11/18,61%)is the most common cause of Rh-HDN.展开更多
目的分析1例胎儿新生儿溶血病(hemolytic disease of the fetus and newborn,HDFN)产生的原因,初步探讨产妇Rh缺失型D--形成的遗传背景。方法使用血清学方法对患儿及其母亲进行ABO血型、Rh分型,血液抗体细胞,谱细胞分析,探讨导致胎儿溶...目的分析1例胎儿新生儿溶血病(hemolytic disease of the fetus and newborn,HDFN)产生的原因,初步探讨产妇Rh缺失型D--形成的遗传背景。方法使用血清学方法对患儿及其母亲进行ABO血型、Rh分型,血液抗体细胞,谱细胞分析,探讨导致胎儿溶血的抗体以及Rh缺失型D--的血型血清学特点,对产妇进行RH基因序列分析。结果患儿母亲血型为O型,血清学试验结果显示Rh缺失型D--,怀疑为多次妊娠产生针对Rh高频抗原的抗-Hr0,抗体通过胎盘屏障,使患儿获得针对Rh高频抗原的抗-Hr0,导致HDFN,基因检测结果为RHCE^(*)Ce/RHCE^(*)Ce。结论对产妇开展Rh缺失型D--的形成机制进行深入研究,为HDFN换血治疗提供临床价值,也为特殊血型人群输血提供临床依据。展开更多
目的回顾性分析襄阳地区23例RH新生儿溶血病(hemolytic disease of the newborn,HDN)患儿情况,为该地区RHHDN的治疗及预防提供支持资料。方法收集自2009年襄阳五家医院开展新生儿溶血病的实验室检测并明确诊断23例RH溶血症患儿的相关资...目的回顾性分析襄阳地区23例RH新生儿溶血病(hemolytic disease of the newborn,HDN)患儿情况,为该地区RHHDN的治疗及预防提供支持资料。方法收集自2009年襄阳五家医院开展新生儿溶血病的实验室检测并明确诊断23例RH溶血症患儿的相关资料,对其标本进行血型鉴定、交叉配血、RH分型、不规则抗体定型、新生儿溶血三项试验,对实验结果进行分析;对确诊的孕妇进行血浆置换,对患儿进行换血治疗,然后观察患儿的胆红素指标以及部分生命体征,对这些指标进行分析。结果 23例患儿母亲的RH(D)阴性20例(87.0%),血清学表型分布为ccdee 9例(39.1%)、Ccdee8例(34.80%)、Ccd Ee2例(8.7%)、Ccd EE1例(4.3%)。另外三例RH表型为cc Dee 2例(8.7%),cc DEe 1例(4.3%)。新生儿的血清学表型分布为cc Dee 5例(21.7%)、Cc Dee3例(13.0%)、cc DEe6例(26.1%)、CCDee2例(8.7%)、Ccd Ee 7例(30.4%)。22例患儿进行换血治疗前、后胆红素对比均有明显降低;术中患儿呼吸、心率、血压、体温及经皮血氧饱和度均稳定,未出现不良反应,未作特殊处理。术后追踪观察1个月,无并发症发生。结论对孕妇和新生儿进行及时准确的实验室检查、孕妇进行血浆置换和药物治疗,以及在及时准确RH-HDN的诊断后采取换血治疗可以有效的预防和治疗RH-HDN。展开更多
Objective:To investigate detection and significance of IgG anti-G in serum and erythrocyte irradiation fluid of patients with Rh hemolytic disease of newborn.Methods:It was sensitized with O ccDee (Ccdee) standard ery...Objective:To investigate detection and significance of IgG anti-G in serum and erythrocyte irradiation fluid of patients with Rh hemolytic disease of newborn.Methods:It was sensitized with O ccDee (Ccdee) standard erythrocyte that the serum and the irradiation fluid contained anti-D or/and anti-C identified with spectra cello. The sensitized erythrocyte was irradiated by indirect coomb test was used to identify IgG anti-G of the irradiation fluid with O Ccdee (ccDee).Results:There were anti-G in 3 patients’ serum or/and irradiation fluid and gravidas’ serum of 11 patients with Rh hemolytic disease and gravidas’o. And gravidas’ Rh blood group were all ccdee.Conclusion:Anti-G can occur in newborn when gravida’s Rh blood group is ccdee. It must be paid attention to that anti-G could intensify patients haemolysis in clinic blood transfusion.展开更多
目的建立巢式PCR技术检测RhD阴性孕妇血浆中游离胎儿DNA(cffDNA)的RHD基因型,以预测胎儿RhD血型。方法采用QIAamp DNA Blood Mini Kit提取32例RhD阴性孕妇血浆游离DNA,针对RHD外显子7和10分别设计外侧、内侧2组特异性引物,巢式PCR方法...目的建立巢式PCR技术检测RhD阴性孕妇血浆中游离胎儿DNA(cffDNA)的RHD基因型,以预测胎儿RhD血型。方法采用QIAamp DNA Blood Mini Kit提取32例RhD阴性孕妇血浆游离DNA,针对RHD外显子7和10分别设计外侧、内侧2组特异性引物,巢式PCR方法检测孕妇血浆游离胎儿DNA的RHD型,测序验证PCR产物的序列特异性。结果孕妇血浆游离DNA经巢式PCR扩增后,有27例成功扩增出RHD外显子7、10特异性条带,5例未检测到RHD基因特异性扩增,32例中有30例胎儿RHD型与出生后血型相符,检测准确率为93.1%。结论采用巢式PCR技术检测RhD阴性孕妇血浆游离胎儿DNA来判定胎儿RHD型,具有良好的准确性、敏感性和特异性,为RhD新生儿溶血病的早期诊断提供了一种新的、可靠的检测手段。展开更多
文摘BACKGROUND Anti-D antibody is not the common cause of Rh-isoimmunization in Chinese neonatal jaundice.Recent change in national population policy has followed by an increase in Rh-isoimmunization related hemolytic disease of the newborn(HDN).Unfortunately,regional status of Rh-HDN is unavailable.We hypothesize that Rh-HDN in our region is most commonly due to anti-E antibody.AIM To investigate the prevalence of hemolytic disease of the newborn due to Rhisoimmunization in Hefei City.METHODS Retrospective review of data obtained from Children’s Hospital of Anhui and Hefei Blood Center between January 2017 and June 2019.Status of minor blood group antibody was studied in the corresponding mothers.RESULTS Totally 4138 newborns with HDN admitted during the study period and 116(2.8%)received blood exchange transfusion(BET).Eighteen newborns(0.43%)with proven Rh-incompatible HDN were identified.All were not the first-born baby.Thirteen mothers were RhD(+)(72%)and five were RhD(-).The distribution of Rh-related antibodies in mothers was ten anti-E(55%),five anti-D(27%),and for one anti-C,anti-c,and anti-E/c(6%)each.Thirteen(72.2%)were qualified for BET,relative risk for BET was 28.9 as compared to other types of HDN,but only 10 received due to parenteral refusal.All(100%)RhD related HDN received BET which is not significantly different from RhE related HDN(81.8%).CONCLUSION As expected,all Rh-incompatible HDN newborns were not the first-born.Contrary to the Caucasian population,anti-D induced HDN is not the most common etiology.In our region,anti-E(11/18,61%)is the most common cause of Rh-HDN.
文摘目的分析1例胎儿新生儿溶血病(hemolytic disease of the fetus and newborn,HDFN)产生的原因,初步探讨产妇Rh缺失型D--形成的遗传背景。方法使用血清学方法对患儿及其母亲进行ABO血型、Rh分型,血液抗体细胞,谱细胞分析,探讨导致胎儿溶血的抗体以及Rh缺失型D--的血型血清学特点,对产妇进行RH基因序列分析。结果患儿母亲血型为O型,血清学试验结果显示Rh缺失型D--,怀疑为多次妊娠产生针对Rh高频抗原的抗-Hr0,抗体通过胎盘屏障,使患儿获得针对Rh高频抗原的抗-Hr0,导致HDFN,基因检测结果为RHCE^(*)Ce/RHCE^(*)Ce。结论对产妇开展Rh缺失型D--的形成机制进行深入研究,为HDFN换血治疗提供临床价值,也为特殊血型人群输血提供临床依据。
文摘目的回顾性分析襄阳地区23例RH新生儿溶血病(hemolytic disease of the newborn,HDN)患儿情况,为该地区RHHDN的治疗及预防提供支持资料。方法收集自2009年襄阳五家医院开展新生儿溶血病的实验室检测并明确诊断23例RH溶血症患儿的相关资料,对其标本进行血型鉴定、交叉配血、RH分型、不规则抗体定型、新生儿溶血三项试验,对实验结果进行分析;对确诊的孕妇进行血浆置换,对患儿进行换血治疗,然后观察患儿的胆红素指标以及部分生命体征,对这些指标进行分析。结果 23例患儿母亲的RH(D)阴性20例(87.0%),血清学表型分布为ccdee 9例(39.1%)、Ccdee8例(34.80%)、Ccd Ee2例(8.7%)、Ccd EE1例(4.3%)。另外三例RH表型为cc Dee 2例(8.7%),cc DEe 1例(4.3%)。新生儿的血清学表型分布为cc Dee 5例(21.7%)、Cc Dee3例(13.0%)、cc DEe6例(26.1%)、CCDee2例(8.7%)、Ccd Ee 7例(30.4%)。22例患儿进行换血治疗前、后胆红素对比均有明显降低;术中患儿呼吸、心率、血压、体温及经皮血氧饱和度均稳定,未出现不良反应,未作特殊处理。术后追踪观察1个月,无并发症发生。结论对孕妇和新生儿进行及时准确的实验室检查、孕妇进行血浆置换和药物治疗,以及在及时准确RH-HDN的诊断后采取换血治疗可以有效的预防和治疗RH-HDN。
文摘Objective:To investigate detection and significance of IgG anti-G in serum and erythrocyte irradiation fluid of patients with Rh hemolytic disease of newborn.Methods:It was sensitized with O ccDee (Ccdee) standard erythrocyte that the serum and the irradiation fluid contained anti-D or/and anti-C identified with spectra cello. The sensitized erythrocyte was irradiated by indirect coomb test was used to identify IgG anti-G of the irradiation fluid with O Ccdee (ccDee).Results:There were anti-G in 3 patients’ serum or/and irradiation fluid and gravidas’ serum of 11 patients with Rh hemolytic disease and gravidas’o. And gravidas’ Rh blood group were all ccdee.Conclusion:Anti-G can occur in newborn when gravida’s Rh blood group is ccdee. It must be paid attention to that anti-G could intensify patients haemolysis in clinic blood transfusion.
文摘目的建立巢式PCR技术检测RhD阴性孕妇血浆中游离胎儿DNA(cffDNA)的RHD基因型,以预测胎儿RhD血型。方法采用QIAamp DNA Blood Mini Kit提取32例RhD阴性孕妇血浆游离DNA,针对RHD外显子7和10分别设计外侧、内侧2组特异性引物,巢式PCR方法检测孕妇血浆游离胎儿DNA的RHD型,测序验证PCR产物的序列特异性。结果孕妇血浆游离DNA经巢式PCR扩增后,有27例成功扩增出RHD外显子7、10特异性条带,5例未检测到RHD基因特异性扩增,32例中有30例胎儿RHD型与出生后血型相符,检测准确率为93.1%。结论采用巢式PCR技术检测RhD阴性孕妇血浆游离胎儿DNA来判定胎儿RHD型,具有良好的准确性、敏感性和特异性,为RhD新生儿溶血病的早期诊断提供了一种新的、可靠的检测手段。
