6例新生儿同种免疫性血小板减少症临床资料回顾分析  

Neonates with alloimmune thromlocytopenia:aretrospectiveanalysis of 6 cases

作　　者：马德冉[1] 赵莉[1] 田野[1] 牛丽玮 韩利霞[1] 邵智利[1] MA Deran;ZHAO Li;TIAN Ye;NIU Liwei;HAN Lixia;SHAO Zhili(Department of BloodTransfusion,Children′s Hospital of Hebei Province,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院输血科,河北石家庄050031

出　　处：《中国输血杂志》2020年第10期1026-1028,共3页Chinese Journal of Blood Transfusion

摘　　要：目的探讨胎儿/新生儿同种免疫性血小板减少症(fetal/neonatal alloimmune thromlocytopenia,FNAIT)的发病机制、临床症状、实验室检查及相关治疗和预防。方法收集2018年10月—2019年8月河北省儿童医院新生儿科收治的6例FNAIT患儿的临床资料,对FNAIT的临床表现、诊断和治疗方法进行总结分析。结果6例患儿中有5例出现皮肤出血点或瘀斑、眼底出血、颅内出血等出血症状,且6例患儿Plt计数均降低,而母亲Plt计数均正常。母子同种免疫性血小板抗体检测均为阳性。6例患儿经IVIG或类固醇激素治疗、2例患儿输注随机供体血小板后,均痊愈出院。结论FNAIT可发生在初次妊娠,一般具有自限性,重症病例可出现颅内出血。应及时关注新生儿血小板减少与母亲免疫性抗体的相关性,尽早干预,以减少FNAIT带来的危害。Objective To investigate the pathogenesis,clinical symptoms,laboratory examination,treatment and prevention of fetal/neonatal alloimmune thromlocytopenia(FNAIT).Methods The clinical data of 6 neonates with FNAIT,admitted to the Neonatal Department of Hebei Children′s Hospital,from October 2018 to August 2019 were collected,and the clinical symptoms,diagnosis and treatment methods were summarized and analyzed.Results There were skin bleeding spots or ecchymosis in 3 cases,fundus hemorrhage in 1 case,intracranial hemorrhage in 3 cases and anemia in 4 cases.2 cases were suspected to have a family history of alloimmune thromlocytopenia.The Plt countsof 6 neonatesall decreased,while the Plt counts of their mothers were normal.All 6 neonates and their mothers were tested positive for alloimmune platelet antibody.3 were treated with IVIG combined with steroid hormone,2 received platelets from random donors,and 3 received red blood cell transfusion.All the 6 neonates were cured and discharged.Conclusion FNAIT,generallyaself-limiteddisease,may occur in the first pregnancy and maybe accompanied within tracranial hemorrhage in severe cases.As a confirmatory test for FNAIT,platelet alloantibody screening inpregnant women is helpful for early detection and treatment of FNAIT.

关 键 词：新生儿同种免疫性血小板减少症 血小板抗体 治疗 预防 

分 类 号：R558.2[医药卫生—血液循环系统疾病] R457.1[医药卫生—内科学]