新生儿溶血病产前诊断的研究现状和进展  

Research status and progress of prenatal diagnosis of hemolytic disease of newborn

作　　者：刘榕孜(综述) 刘峰(审校) LIU Rongzi;LIU Feng(Department of Blood Transfusion,the First Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530021,China)

机构地区：[1]广西医科大学第一附属医院输血科,广西南宁530021

出　　处：《国际检验医学杂志》2022年第17期2161-2164,共4页International Journal of Laboratory Medicine

摘　　要：胎儿及新生儿溶血性疾病(HDFN)是由于母体先天或后天出现针对胎儿及新生儿红细胞抗原的致病性抗体,通过胎盘进入胎儿及新生儿体内引起的同种免疫性溶血。当前针对HDFN的妊娠管理包括产前孕妇及配偶血型表型鉴定、母体致病性抗体的检测及其效价滴定,高风险时进行羊膜穿刺等侵入性诊断操作或实施宫内输血治疗。目前已出现许多新技术,非侵入性诊断技术如利用孕妇外周血胎儿游离DNA(cff-DNA)进行胎儿血型基因分型、多普勒检测胎儿大脑中动脉峰值流速(MCA-PSV)诊断胎儿贫血等已在临床使用。本文将对国内外HDFN产前诊断技术现状及其研究新进展做一综述,以利于实施更安全有效的HDFN诊断治疗和妊娠管理。Hemolytic disease of the fetus and newborn(HDFN)is an autoimmune hemolysis caused by the presence of pathogenic antibodies against fetal and neonatal erythrocyte antigens in the mother,which enter the fetus and newborn through the placenta.Current pregnancy management for HDFN includes prenatal blood type and phenotype identification of pregnant women and their spouses,detection and titer titration of maternal pathogenic antibodies,amniocentesis and other invasive diagnostic procedures or intrauterine blood transfusion treatment in high-risk cases.At present,many new techniques have emerged.Non-invasive diagnostic techniques such as fetal blood type genotyping using cell-free fetal DNA(cff-DNA)in pregnant women′s peripheral blood,detection of the middle cerebral artery peak systolic velocity(MCA-PSV)by Doppler in the diagnosis of fetal anemia,have been used in clinics.This article will review the research status and new research progress of prenatal diagnosis technology of HDFN at home and abroad,in order to implement more safe and effective diagnosis and treatment of HDFN and pregnancy management.

关 键 词：新生儿溶血病 红细胞抗原和抗体 诊断技术 妊娠管理 胎儿基因 

分 类 号：R714.5[医药卫生—妇产科学]