新生儿Rh溶血病血清抗体、血红蛋白、胆红素峰值水平检测及临床意义  

Detection and clinical significance of serum antibody,hemoglobin,and bilirubin peak levels in neonatal Rh hemolytic disease

作　　者：王倩菲 杨金英 WANG Qian-fei;YANG Jin-ying(Department of Neonatology,the Fourth Hospital of Xi'an City,Xi’an 710000,Shaanxi,CHINA)

机构地区：[1]西安市第四医院新生儿科,陕西西安710000

出　　处：《海南医学》2021年第21期2772-2775,共4页Hainan Medical Journal

摘　　要：目的探讨新生儿Rh溶血病患儿的血清抗体、血红蛋白(Hb)、胆红素峰值水平及其临床意义。方法回顾性分析2018年1月至2020年9月西安市第四医院收治的60例新生儿Rh溶血病患儿临床资料,根据是否需要接受换血治疗分为重症组37例和轻症组23例。比较两组患儿的一般资料、入院时血清抗体分布情况及Hb和胆红素峰值水平,并记录重症组患儿换血后的Hb和胆红素峰值水平。结果重症组患儿出生后黄疸发生时间为(14.95±3.85)h,明显早于轻症组的(20.31±3.02)h,黄疸持续时间为(8.51±2.16)d,明显长于轻症组的(6.04±1.37)d,差异均有统计学意义(P<0.05);重症组患儿的血清抗-D、抗-E、抗-cE、抗-C、抗-c、抗-Ce所占比例分别为62.16%、18.92%、8.11%、5.41%、2.70%、2.70%,轻症组分别为60.87%、21.74%、4.35%、4.35%、4.35%、4.35%,差异均无统计学意义(P>0.05);重症组患儿入院时Hb水平为(91.57±6.04)g/L,明显低于轻症组的(130.14±7.40)g/L,胆红素峰值水平为(451.92±36.74)μmol/L,明显高于轻症组的(241.33±20.51)μmol/L,差异均有统计学意义(P<0.05);换血后,重症组患儿的Hb水平为(125.82±8.25)g/L,明显高于换血前,胆红素峰值水平为(211.39±24.03)μmol/L,明显低于换血前,差异均有统计学意义(P<0.05)。结论新生儿Rh溶血病血清抗体主要以抗-D、抗E为主,病情较重患儿的Hb水平表达降低,胆红素峰值水平表达升高,有助于评估病情程度。Objective To investigate the expression and clinical significance of serum antibody,hemoglobin(Hb),bilirubin peak level in neonatal Rh hemolytic disease.Methods The clinical data of 60 patients of newborn Rh hemolytic disease in the Fourth Hospital of Xi'an City from January 2018 to September 2020 were analyzed.The patients were divided into severe group(n=37)and mild group(n=23)according to whether they needed exchange transfusion.The general information,the distribution of serum antibody,and the expression of serum peak serum Hb and bilirubin levels were compared between the two groups,and the serum Hb and bilirubin peak levels after exchange transfusion in the severe group was recorded.Results The jaundice after birth time in severe group was(14.95±3.85)h,which was significantly earlier than(20.31±3.02)h in mild group,and the jaundice duration time was(8.51±2.16)d,which was significantly longer than(6.04±1.37)d in mild group,with statistically significant difference(P<0.05);the proportion of serum anti-D,anti-E,anti-cE,anti-C,anti-c,and anti-Ce in severe group were 62.16%,18.92%,8.11%,5.41%,2.70%,and 2.70%,versus 60.87%,21.74%,4.35%,4.35%,4.35%,and 4.35%in mild group(P>0.05).The serum Hb level at admission in severe group was(91.57±6.04)g/L,which was significantly lower than(130.14±7.40)g/L in mild group,and the bilirubin peak level was(451.92±36.74)μmol/L,which was significantly higher than(241.33±20.51)μmol/L in mild group,with statistically significant difference(P<0.05).After exchange transfusion,the serum Hb level in the severe group was(125.82±8.25)g/L,which was significantly higher than that in before exchange transfusion,and the bilirubin peak level was(211.39±24.03)μmol/L,which was significantly lower than that before exchange transfusion,with statistically significant difference(P<0.05).Conclusion The main serum antibodies of newborn Rh hemolytic disease are anti-D and anti-E,and in children with severe disease,the Hb expression levels decreased,and the peak levels of bilirubin expressio

关 键 词：新生儿 RH溶血病 血清抗体 血红蛋白 胆红素峰值 换血 

分 类 号：R722.18[医药卫生—儿科]