C反应蛋白和白细胞在足月新生儿ABO溶血病中的临床观察  

Clinical observation of C reactive protein and white blood cell in ABO hemolytic disease of full-term neonates

作　　者：程艳超[1] 徐发林[1] 霍婉莹 孟二艳 李书津[1] CHENG Yanchao;XU Falin;HUO Wanying;MENG Eryan;LI Shujin(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州大学第三附属医院新生儿科,河南郑州450000

出　　处：《中国医学工程》2023年第5期95-99,共5页China Medical Engineering

摘　　要：目的探讨C反应蛋白(CRP)和白细胞(WBC)在足月新生儿ABO溶血病(ABO HDN)中的临床特点,为新生儿ABO溶血病的早期识别提供一些参考依据,并对临床合理使用抗菌药物提供指导。方法选取2018年6月至2022年6月郑州大学第三附属医院新生儿科的足月新生儿ABO溶血病进行回顾性分析。将入选患儿根据年龄进行分组,分析对比入院后的CRP及WBC值、抗菌药物使用及感染症状发生情况。结果共有409例新生儿ABO溶血病患儿纳入研究,按年龄进行分组,其中<6 h龄组57人,6 h~24 h龄组74人,24 h~48 h龄组119人;48 h~72 h龄组78人;>72 h龄组81人。5组患儿CRP异常检出率依次为0、37.8%、24.4%、12.8%、1.2%。5组患儿WBC异常检出率依次为10.5%、21.6%、8.4%、1.3%、0。ABO HDN患儿中CRP或WBC异常者应用抗菌药物组与未用抗菌药物组比较,感染症状发生率差异均无统计学意义(P>0.05)。结论ABO HDN患儿免疫性溶血反应可导致出生早期CRP及WBC异常增高,CRP异常多于生后6 h开始出现,生后72 h恢复正常,WBC异常多发生于生后48 h内,生后48 h恢复正常;ABO溶血病患儿早期出现CRP或WBC异常并非一定是存在感染,可能是溶血反应导致,若无感染症状,可暂不给予抗菌药物。【Objective】To explore the clinical characteristics of C-reactive protein(CRP)and white blood cell(WBC)in ABO hemolytic disease of full-term neonates,and to provide some reference basis for the early identification of ABO hemolytic disease of newborn,and to provide guidance for the clinical rational use of antibiotic.【Methods】ABO hemolytic disease of full-term neonates in the Neonatology Department of the Third Affiliated Hospital of Zhengzhou University from June 2018 to June 2022 was retrospectively analyzed.The selected children were divided into groups according to their age,and the values of CRP and WBC,the use of antibiotics and the occurrence of infection symptoms after admission were analyzed and compared.【Results】A total of 409 neonatal children with ABO hemolytic disease were included in the study and grouped according to age,including 57 in<6h age group,74 in 6h to 24h age group,119 in 24h to 48h age group,78 in 48h to 72h age group,and 81 in>72h age group.The abnormal detection rates of CRP in 5 groups were 0,37.8%,24.4%,12.8%and 1.2%respectively.The abnormal detection rate of WBC in 5 groups were 10.5%,21.6%,8.4%,1.3%and 0 respectively.In ABO HDN children with abnormal CRP,there was no statistically significant difference in the incidence of infection symptoms between the antibiotic group and the non-antibiotic group(4.8%vs.3.8%,P>0.05).In ABO HDN children with CRP or leukocyte abnormalities,there was no statistical significance in the incidence of infection symptoms between the antibiotics group and the group without antibiotics(P>0.05).【Conclusion】Immunohemolysis in ABO HDN children can lead to abnormal increase of CRP and WBC in early birth.The abnormal CRP starts to appear more than 6h after birth and returns to normal 72h after birth.The abnormal WBC mostly occurs within 48h after birth and returns to normal 48h after birth.Abnormal CRP or WBC in children with ABO hemolytic disease at the early stage is not necessarily due to the presence of infection,but may be caused by hemolyti

关 键 词：新生儿ABO溶血病 C反应蛋白 白细胞 感染 

分 类 号：R446[医药卫生—诊断学]