新生儿溶血病患儿临床资料与溶血程度关系的研究  

Study and analysis of correlation of clinical characteristics and degree of hemolysis and anemia in newborn children with hemolytic disease

作　　者：刘建朝 王亚红[2] 贺锋 LIU Jianchao;WANG Yahong;HE Feng(Medical Laboratory,Hunan College of Occupational Disease Control,Changsha,410007,China;Laboratory of 921 Hospital of the Joint Service Support Force of the People's Liberation Army;Blood Transfusion Department of Zhuzhou Central Hospital)

机构地区：[1]湖南省职业病防治院医学检验科,长沙410007 [2]中国人民解放军联勤保障部队第921医院检验科 [3]株洲市中心医院输血科

出　　处：《临床血液学杂志》2021年第2期105-108,共4页Journal of Clinical Hematology

基　　金：湖南省卫生健康委科研计划项目(No:20201481)。

摘　　要：目的:探讨新生儿溶血病(HDN)患儿不同性别、疾病类型、确诊日龄、直接抗人球蛋白试验(DAT)凝集强度与溶血、贫血程度关系。方法:分析2016年1月—2019年12月确诊HDN患儿104例,检测所有患儿总胆红素(TBIL)、乳酸脱氢酶(LDH)、血红蛋白(Hb)浓度,根据患儿性别、疾病类型、确诊日龄、DAT凝集强度分成不同组别,比较各组间TBIL、LDH、Hb浓度差异,并分析临床资料与溶血、贫血指标关系。结果:104例HDN患儿中,男48例,占46.15%,女56例,占53.85%,不同性别患儿TBIL、LDH、Hb浓度差异均无统计学意义(均P>0.05)。Rh-HDN患儿TBIL、LDH均高于ABO-HDN,Hb浓度低于ABO-HDN,差异均有统计学意义(均P<0.05);ABO-HDN患儿中,O-A组TBIL浓度高于O-B组,Hb浓度低于O-B组,差异均有统计学意义(均P<0.05);O-AB组TBIL均高于O-A组和O-B组,Hb低于O-B组,差异均有统计学意义(均P<0.05);Rh-HDN患儿中,抗-D组TBIL、LDH均高于抗-E/C/Ce组,差异均有统计学意义(均P<0.05)。确诊日龄<4 d患儿TBIL、LDH浓度低于4~7 d组和>7 d组,确诊日龄4~7 d组TBIL浓度低于>7 d组,差异均有统计学意义(均P<0.05)。DAT4+组TBIL、LDH浓度高于3+、2+、≤1+组,Hb浓度低于2+、≤1+组,DAT3+组TBIL、LDH浓度高于2+、≤1+组,差异均有统计学意义(均P<0.05)。Rh-HDN患儿容易引起TBIL、LDH升高和Hb降低,确诊日龄、DAT凝集强度与TBIL、LDH呈正相关,DAT凝集强度与Hb呈负相关(均P<0.05)。结论:HDN患儿性别与溶血、贫血程度无关,对于Rh引起的HDN、确诊日龄>7 d、DAT凝集强度≥3+患儿,应密切关注TBIL和Hb变化情况,及时采取相关措施,防止胆红素脑病发生。Objective: To analyze the relationship between different gender, disease types, age of diagnosis, agglutination intensity of direct anti-human globulin test and degree of hemolysis and anemia in newborn children with hemolytic disease(HDN). Methods: A total of 104 cases of HDN newborn children who were diagnosed in our hospital from January 2016 to December 2019 were analyzed, and total bilirubin(TBIL), lactate dehydrogenase(LDH), hemoglobin(Hb) concentrations of all children were detected. According to gender, disease type, age of diagnosis and DAT agglutination intensity, all children were divided into different groups, and the differences in TBIL, LDH, Hb concentrations between the groups were compared and statistically analyzed. Results: Of the 104 HDN children, 48 cases were male, accounting for 46.15%, and 56 cases were female, accounting for 53.85%. There were no statistically significant differences in the concentrations of TBIL, LDH, and Hb among children of different genders(all P>0.05). Children with Rh-HDN had higher TBIL and LDH than that of ABO-HDN, and Hb concentration was lower than that of ABO-HDN, the differences were statistically significant(all P<0.05). Among the ABO-HDN patients, the TBIL concentration in the O-A group was higher than that in the O-B group, and the Hb concentration was lower than that in the O-B group. The differences were statistically significant(both P<0.05). The TBIL in the O-AB group was higher than that in the O-A group and O-B group, and the Hb was lower than that in the O-B group, the difference was statistically significant(both P<0.05). Among Rh-HDN patients, TBIL and LDH in anti-D group were higher than those in anti--E/C/Ce group, and the differences were statistically significant(both P<0.05). The TBIL concentration in the diagnosed day 4-7 days group was lower than that in the>7 day group, and the differences were statistically significant(both P<0.05). TBIL and LDH concentrations in DAT4 + group were higher than those in 3+, 2+, ≤1 + group, Hb concentration

关 键 词：新生儿溶血病 RH血型系统 ABO血型系统 溶血程度 直接抗人球蛋白试验 

分 类 号：R722.18[医药卫生—儿科]