抗-E合并抗-Jk^b致新生儿溶血病1例及文献复习  

Anti-E and anti-Jkb causing hemolytic disease of newborn： one case report and literatures review

作　　者：迟媛媛 秦洪伟 韩斌 

机构地区：[1]山东省青岛市妇女儿童医院输血科,266000 [2]山东省青岛市胶州中心医院输血科,266000 [3]山东省青岛市中心血站输血医学研究所,266000

出　　处：《国际输血及血液学杂志》2017年第2期154-157,共4页International Journal of Blood Transfusion and Hematology

摘　　要：目的总结抗-E合并抗-Jk^b致新生儿溶血病（HDN）的临床诊疗经验。方法选择2015年4月3日于青岛市妇女儿童医院收治的1例抗E合并抗-Jk^b致HDN的患儿作为研究对象。患儿因“出生后全身黄疸进行性加重”从外院转至本院，初步诊断为Rh血型不合HDN。经相关实验室检查结果证实患儿存在不规则抗体抗-E和抗一-Jk^b后，及时给予换血及输血治疗，监测总胆红素（TBIL）、间接胆红素（IBIL）水平等指标，观察患儿转归，探讨治疗效果，并且进行相关文献复习。结果患儿入本院治疗时TBII。水平为303．5μmol／L、IBIL水平为291．6μmol／L；对症治疗3h后（换血治疗前），TBIL和IBIL水平分别升高至333．5μmol／L、316．5μmol／L；换血治疗后TBIL和IBIL水平明显降低，分别为219．6μmol／L、203．4μmo1／L。该患儿住院治疗10d后，各项实验室指标均恢复至正常水平，于2015年4月12日出院。结论加强基层医院对Rh血型和孕妇免疫性血清抗体筛查的认识，在准确诊断为重症HDN后采取换血治疗，可以有效的预防和治疗HDN。Objective To summarize the experience of diagnosis and treatment of hemolytic disease of newborn （HDN） caused by anti-E and anti-Jkb. Methods On 3rd April 2015, one case of newborn with hemolytic disease caused hy anti-E and anti-Jkb in Qingdao Women and Children Hospital was selected as the research object. This newborn was transferred from other hospital because of systemic jaundice after birth and was diagnosed as Rh blood system HDN originally. The results of laboratory tests confirmed that the presence of irregular antibodies anti-E and anti-Jk^b in this newborn. And blood exchange transfusion and blood transfusion treatments were carried out immediately. Moreover, some indicators such as levels of total bilirubin （TBIL）, indirect biliruhin （IBIL） and so on were monitored in order to observe the prognosis of disease and discuss the curative effects. And related literatures were reviewed. Results Levels of TBIL and IBIL were 303.5 /,mol/L and 291.6 μmol/L, respectively, when this newborn was hospitalized; and they rose to 333.5 μmol/L. and 316. 5 μmol/L, respectively, after 3 h of symptomatic treatment. Then they reduced to 219. 6 μmol/L and 203.4 gmol/L, respectively, after the blood exchange transfusion. This newborn＇s laboratory indexs were recoveried to the normal range after 10 days of hospitaliation, and left hospital on 12th April 2015. Conclusions Strengthen the understanding of Rh blood group and serum antibody screening of pregnant women in primary hospitals, timely and accurate diagnosis on severe HDN and then blood exchange transfusion therapy could prevent and treat HDN effectively.

关 键 词：RH-HR血型系统 KIDD血型系统 幼红细胞增多症 胎儿 

分 类 号：R722.18[医药卫生—儿科]