新生儿葡萄糖-6-磷酸脱氢酶缺乏症合并ABO血型不合溶血病所致高胆红素血症的临床分析  

Clinical Analysis of Neonatal Hyperbilirubinemia Caused by Glucose-6-Phosphate Dehydrogenase Deficiency Combine with ABO Blood Group Incompatibility Hemolysis

作　　者：杨丽[1,2] 高于[1] 夏斌[1] 韩雪芹[1] 高洁[1,3] 

机构地区：[1]四川大学华西第二医院儿科,成都610041 [2]四川省长宁县人民医院儿科 [3]四川省蒲江县人民医院儿科

出　　处：《中华妇幼临床医学杂志（电子版）》2014年第3期26-29,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金资助项目(81370738);国家临床重点专科建设项目(1311200003303);四川省卫生和计划生育委员会科学研究项目(060026)~~

摘　　要：目的探讨新生儿葡萄糖-6-磷酸脱氢酶(G-6-PD)缺乏症合并ABO血型不合溶血病与单纯G-6-PD缺乏症及单纯ABO血型不合溶血病所致高胆红素血症的临床表现和实验室检查结果差异。方法选择2008年1月至2012年12月于四川大学华西第二医院新生儿科住院治疗并确诊为新生儿G-6-PD缺乏症及新生儿ABO血型不合溶血病共计643例足月新生儿为研究对象。按照所罹患的疾病将其分为:A组(n=20,G-6-PD缺乏症+ABO血型不合溶血病),B组(n=52,单纯G-6-PD缺乏症)及C组(n=571,单纯ABO血型不合溶血病)。采用回顾性分析方法,比较3组患儿的临床表现及实验室检查结果(本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人知情同意,并与监护人签署临床研究知情同意书)。3组患儿出生体质量、胎龄及分娩方式比较,差异无统计学意义(P>0.05)。结果本研究结果为:①A组性别构成比及生后24h内黄疸发生率与B组比较,差异均有统计学意义(χ2=9.010,9.013;P=0.003,0.003);与C组比较,差异均无统计学意义(χ2=1.670,1.408;P=0.196,0.235)。②A组入院日龄及黄疸出现时间与B组比较,差异均有统计学意义(P<0.001,P=0.017);与C组比较,差异均无统计学意义(P=0.805,0.074)。③A组血清胆红素浓度峰值及急性胆红素脑病发生率与B组比较,差异均无统计学意义(P=0.108;χ2=0.633,P=0.426);与C组比较,差异亦均无统计学意义(P=0.837;χ2=0.000,P=1.000)。结论单纯G-6-PD缺乏症新生儿的黄疸出现时间与生理性黄疸重叠,易延误其就诊而导致严重高胆红素血症和胆红素脑病;当G-6-PD缺乏症合并ABO血型不合溶血病时,新生儿的黄疸出现时间提前,更易使患儿得到早期治疗而减少严重并发症的发生。Objective To investigate the clinical manifestations and laboratory examination results of the neonatal hyperbilirubinemia caused by glucose-6-phosphate dehydrogenase （G-6-PD） deficiency combine with ABO blood group incompatibility hemolysis to the G-6-PD deficiency or the ABO blood group incompatibility hemolysis.Methods A total of 643 cases of full-term newborn infant which were treated and diagnosed as neonatal G-6-PD deficiency and ABO blood group incompatibility hemolysis hospitalized in West China Second University Hospital,Sichuan University from January 2008 to December 2012 were chosen as study subjects.According to the types of diseases,they were divided into 3 groups：group A （n=20,G-6-PD deficiency combine with ABO blood group incompatibility hemolysis group）,group B （n=52,G-6-PD deficiency group）,group C （n =571,ABO blood group incompatibility hemolysis group）.The clinical manifestations and laboratory results were analyzed.The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of West China Second University Hospital,Sichuan University.Informed consent was obtained from the parents of each participating patient.There were no significant differences about birth weight,gestation age and modes of delivery among three groups （P 〉 0.05）.Results The study results were：① Gender constituent ratio and jaundice incidence within 24 h after birth of group A compared with group B,the differences were statistically significant（χ^2 =9.010,9.013; P =0.003,0.003）;but compared with group C,there were no statistically significant difference（χ^2=1.670,1.408;P=0.196,0.235）.②The hospitalized age and the time point of visible jaundice of group A compared with group B,the differences were statistically significant （P〈0.001,P =0.017） ; but compared with group C,there were no statistically significant difference（P=0.805,0.074）.③ Peak amplitude of serum bilirubin level and the incidence rate of acute bilirubin encephalopathy of group A co

关 键 词：葡萄糖磷酸脱氢酶缺乏 ABO血型系统 高胆红素血症 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]