对HDFN发病预判因素的研究  

Prognostic factors of hemolytic disease of the fetus and newborn incidence

作　　者：陆琼[1] 金沙[1] 刘曦[1] 范亮峰[1] 向东[1] 

机构地区：[1]上海市血液中心,上海200051

出　　处：《中国输血杂志》2016年第9期938-940,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨O型产妇血清中IgG抗-A/B效价、新生儿出生天数和新生儿总胆红素数值,三者与ABO-HDFN阳性发病率之间的相关性研究。方法采用血清学方法对随机102例新生儿ABO溶血病检测及其O型母亲血样标本进行IgG抗-A/B效价检测,以及新生儿总胆红素检测。结果 102例新生儿溶血病(HDFN)检测中,证实为ABO-HDFN的病例为65例(63.7%),非ABO-HDFN的病例为37例(36.3%)。通过得到的HDFN预判L值(T×B/D=L),当L值在0-200区间时,HDFN阳性率为0.00%;L值在201-400区间时,HDFN阳性率为30.77%;L值在401-800区间时,HDFN阳性率为87.50%;L值在801-1600区间时,HDFN阳性率为93.33%;L值在1601-3200区间时,HDFN阳性率为93.75%;L值在>3201时,HDFN阳性率为100.00%;L值<200时,ABO-HDFN阴性率可达到100%。结论 HDFN预判值L可作为对HDFN的临床判定依据之一,可加快诊断治疗时间,避免核黄疸等重型病的发生。Objective To investigate the relationship between O type maternal serum anti-A（B） IgG titers, newborn g birth date and neonatal total bilirnbin value, and their correlation with the incidence of ABO hemolytic disease of the fetus and newborn. Methods 102 random cases of ABO hemolytic disease of newborn, their O type mother＇s serum anti-A （B） IgG titers and neonatal total bilirnbin were detected through serological method. Results During the detection of 102 hemolytic disease of newborn cases, 65 （63.83%） were detected to have ABO hemolytic disease of the fetus and newborn, 37 （36. 27% ） did not have ABO hemolytic disease of newborn. Through the obtained estimated L value of hemolytic disease of the fetus and newborn （ T × B/D = L）, when L was in the range of 0 - 200, the positive rate of hemolytic disease of the fetus and newborn was 0. 00% ; when L =201 -400, the positive rate was 30. 77% ; when L =401 - 800, the positive rate was 87.50% ; when L = 801 - 1600, the positive rate was 93.33% ; when L = 1601 - 3200, the positive rate was 93.75% ; when L 〉 3201, the positive rate was 100. 00% ; when L 〈 200, the negative rate was 100. 00%. Conclusion The estimated L value of hemolytic disease of the fetus and newborn can be one of the evidence to clinically determine hemolytic disease of the fetus and newborn and expedite the diagnosis and treatment, in order to avoid the occurrence of severe disease, such as kernicterns.

关 键 词：HDFN IgG抗-A/B 抗体 效价 出生天数 总胆红素 

分 类 号：R457.1[医药卫生—治疗学] R556.63[医药卫生—临床医学]