“二孩”母婴结局与新生儿Rh溶血病的关联  

Relationship between maternal and infant outcomes of "two-child" and Rh hemolysis disease of newborn

作　　者：金方思 陈通[2] 黄颖[1] 林甲进[1] JIN Fangsi;CHEN Tong;HUANG Ying;LIN Jiajin(The Second Affiliated Hospital of Wenzhou Medical College,Wenzhou,325027,China;Central Blood Station of Wenzhou)

机构地区：[1]温州医科大学附属第二医院输血科,浙江温州325027 [2]温州市中心血站

出　　处：《临床血液学杂志》2021年第6期428-431,共4页Journal of Clinical Hematology

摘　　要：目的:探讨"二孩"的母婴结局与新生儿Rh溶血病(Rh-HDN)的关联。方法:随机选取2019年7月—2020年7月检查的512例"二孩"新生儿及其母亲作为研究组,同期530例"一孩"新生儿及其母亲作为对照组,检测2组新生儿及其母亲的Rh血型、不规则抗体及抗体效价,记录Rh-HDN发生情况;比较2组Rh-HDN的发生率,对Rh-HDN患儿的治疗及结局进行分析。结果:研究组发现12例(2.34%)母亲不规则抗体阳性,对照组发现2例(0.38%)母亲不规则抗体阳性,差异有统计学意义(P<0.05);研究组发现Rh-HDN 10例(1.95%);对照组发现Rh-HDN 1例(0.19%),差异有统计学意义(P<0.05);11例Rh-HDN患儿,5例治愈出院;5例预后不佳,好转出院;1例拒绝治疗自行出院。结论:"二孩"比"一孩"出现Rh-HDN的概率大;"二孩"孕妇产前应注重不规则抗体筛查,Rh 5种抗原检测,为临床治疗提供依据。Objective: To explore the relationship between maternal and infant outcomes of "two-child" and Rh hemolysis disease of newborn(Rh-HDN). Methods: A total of 512 "two-child" newborns and their mothers examined in our hospital from July 2019 to July 2020 were randomly selected as the research group, and 530 "one-child" newborns and their mothers during the same period were randomly selected as the control group. The Rh blood type, irregular antibodies and antibody titers of the newborns and their mothers in the two groups were detected, and the occurrence of Rh-HDN was recorded. The incidence of Rh-HDN in the two groups was compared, and the treatment and outcome of children with Rh-HDN were analyzed. Results: In the study group, 12 cases(2.34%) of mothers were positive for irregular antibodies, and 2 cases(0.38%) of mothers were positive for irregular antibodies in the control group, the difference was statistically significant(P<0.05). In the study group, 10 cases(1.95%) were Rh-HDN, and 1 case(0.19%) was Rh-HDN in the control group, the difference was statistically significant(P<0.05). Among the 11 children with Rh-HDN, 5 cases were cured and discharged;5 cases had poor prognosis and were discharged after improvement, and 1 case refused treatment and self-discharged. Conclusion: "Two-child" newborns might be more likely to have Rh-HDN than "one-child" newborns. Prenatal screening of irregular antibodies and Rh 5 antigens should be paid attention to "two-child" pregnant women, so as to provide basis for clinical treatment.

关 键 词：二孩 新生儿RH溶血病 不规则抗体 RH血型 

分 类 号：R556.6[医药卫生—血液循环系统疾病]