新生儿溶血病发病概况及与TORCH相关性分析  

The incidence of neonatal hemolytic disease and its correlation with TORCH

作　　者：袁志美 方礼琳 唐斌[1] 严维强 廖安飞 付甫海 YUAN Zhimei;FANG Lilin;TANG Bin;YAN Weiqiang;LIAO Anfei;FU Fuhai(Department of Laboratory Medicine,Zunyi Maternal and Child Health Hospital,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义市妇幼保健院检验科,贵州遵义563000

出　　处：《国际检验医学杂志》2021年第S01期34-37,共4页International Journal of Laboratory Medicine

基　　金：遵义科合社字项目(2018)220号。

摘　　要：目的探讨新生儿溶血病(HDN)发病概况及与TORCH相关性,为HDN的影响因素、监测指标和疾病关联性等提供重要的参考依据。方法随机抽取2017-2018年该院新生儿科住院筛查HDN的检测样本315例,对比不同性别、血型和筛查时段的新生儿在HDN发病率上的差异性,探讨HDN的发生对机体胆红素和肾功能的影响,研究HDN引起的免疫性溶血和TORCH导致的免疫反应之间的相关性。结果随机抽取的315例新生儿中,不同性别新生儿在HDN发病率上差异无统计学意(χ^(2)=1.47,P=0.225)。A、B、O和AB 4种血型各占144、97、69和5例,其相关的HDN患病率分别是61.10%、38.90%、0.00%和0.00%。比较不同血型HDN的发病率差异有统计学意义(χ^(2)=150.34,P=0.000),主要以A和B型血为主。本课题将新生儿筛查HDN的年龄分为1~3 d、4~6 d和大于等于7 d 3个组,分析3组HDN阳性确诊率(55.40%、30.90%、13.70%)有差异性(χ^(2)=9.38,P=0.009)。对比各HDN阳性对照组的胆红素值均高于阴性组(t=-2.48、-2.55、-2.00,P<0.05)。结论不同性别新生儿在HDN的发生率上无差异性。不同血型HDN的发生率具有差异性,主要以A型和B型血为主。出生不同时段筛查HDN对溶血病的确诊率有影响。可见,早期血型血清学检测在HDN的早期诊断和前期预判中具有重要的作用。HDN的发生对胆红素和CREA有影响。早期胆红素的干预和肾功能的监测至关重要。HDN和TORCH两种病因引起的免疫性疾病之间具有相关性。Objective To study the incidence of hemolytic disease of the newborn(HDN)and its correlation with TORCH,provide an important reference for the influencing factors,monitoring indicators and disease correlation of HDN.Methods A random sample of 315 cases of HDN screening in the Department of Neonatology of Zunyi Maternal and Child Health Hospital from 2017 to 2018 was selected to compare the differences of different genders,blood types and screening ages,and to explore the impact of HDN on the body′s bilirubin and renal function.To study the correlation between immune hemolysis caused by HDN and immune response caused by TORCH.Results The study randomly selected 315 newborns,and the analysis showed that there was no difference in the incidence of HDN among newborns of different genders(χ^(2)=1.47,P=0.225).The four blood types A,B,O,and AB were 144,97,69,and 5 cases,respectively,and the related HDN prevalence was 61.10%,38.90%,0.00%and 0.00%,respectively.Comparing the incidence of HDN with different blood types is different(χ^(2)=150.34,P=0.000),mainly with blood types A and B.In this project,the age of newborn screening for HDN is divided into three groups:1 to 3 days,4 to 6 days,and 7 days or more.The analysis of the three groups has differences(χ^(2)=9.38,P=0.009)in the positive diagnosis rate of HDN.(55.40%,30.90%,and 13.70%).The comparison shows that the bilirubin(TBIL、DBIL、IB)value of each HDN positive control group is higher than the negative group(t=-2.48,-2.55,-2.00,P<0.05).Conclusion There is no difference in the incidence of HDN among newborns of different genders.The incidence of HDN of different blood types is different,mainly with type A and type B blood.Screening for HDN at different times of birth has an impact on the diagnosis of hemolytic disease.It can be seen that early blood group serological testing plays an important role in the early diagnosis and early prediction of HDN.The occurrence of HDN has an impact on bilirubin and CREA.It is very important early bilirubin intervention and re

关 键 词：新生儿溶血病 发病率 TORCH 

分 类 号：R72[医药卫生—儿科]