ABO溶血症患儿实验室结果与溶血 贫血程度的相关性分析  

Correlation analysis between laboratory results and degree of hemolysis in children with ABO-HDN

作　　者：李娲 吴旭良 聂锦标 单款玲 Li Wa;Wu Xuliang(The Guangzhou Zengcheng Maternal and Child Health Hospital,Guangzhou,Guangdong 511300)

机构地区：[1]广州市增城区妇幼保健院,广东广州511300

出　　处：《基层医学论坛》2023年第23期100-103,共4页The Medical Forum

摘　　要：目的 探讨新生儿ABO溶血症(ABO-HDN)患儿不同性别、确诊日龄、母婴血型类别、直接抗人球蛋白试验(DAT)凝集强度与新生儿患儿的溶血、贫血程度的关系。方法 对2020年1月—2021年10月期间确诊的255例ABO-HDN病例进行分析,检测所有患儿的溶血三项和红细胞计数(R BC)、血红蛋白浓度(HB)、血小板计数(platelet count,PLT)、总胆红素(total bilirubin,TBIL)、间接胆红素(indirect bilirubin,IBIL)、乳酸脱氢酶(lactate dehydrogenase,LDH),根据患儿性别、确诊日龄、血型类别、DAT凝集强度等分成不同组别,比较各组间R BC、HB、PLT、TBIL、IBIL、LDH差异,并分析病例临床资料与溶血、贫血之间的关系。结果 不同性别患儿HDN溶血程度比较差异无统计学意义(P>0.05);确诊日龄为1~2 d组患儿的PLT、TBIL、IBIL水平低于确诊日龄为3 d及以上组,LDH水平高于确诊日龄为3 d及以上组(P<0.05);O-A组患儿RBC、HB水平高于O-B组(P<0.05),TBIL、IBIL、LDH水平低于O-B组(P<0.05);O-AB组患儿TBIL、IBIL水平低于O-A组和O-B组(P<0.05),RBC计数高于O-B组(P<0.05);不同DAT凝集强度的患儿相比较其溶血程度差异无统计学意义(P> 0.05)。结论 HDN患儿的贫血溶血程度与性别差异关联度较小、与DAT凝集强度无关,与HDN确诊日龄、不同母婴血型关联度较大,对于确诊日龄≤2 d、母婴血型为O-A、O-B的患儿,应尽早做溶血三项试验以明确诊断,密切关注R BC、HB、TBIL和IBIL水平的变化情况。Objective To explore the relationship between different gender,age of diagnosis,maternal and infant blood group,direct antiglobulin test(DAT)agglutination intensity and the degree of hemolysis and anemia in newborns with ABO hemolysis(ABO-HDN).Methods 255 cases ofABO-HDN diagnosed fromJanuary 2020 to October 2021 were analyzed.The hemolysis,erythrocyte count(RBC),hemoglobin concentration(HB),platelet count(PLT),total bilirubin(TBIL),indirect bilirubin(IBIL)and lactate dehydrogenase(LDH)were measured according to the sex,age of diagnosis,blood type Dat agglutination intensity was divided into different groups.The differences of RBC,Hb,PLT,TBIL,IBIL and LDH among the groups were compared,and the relationship between clinical data and hemolysis and anemia was analyzed.Results there was no significant difference in the degree of HDN hemolysis between children of different genders(P>0.05).The levels of PLT,TBIL and IBIL in 1-2D group were significantly lower than those in 3D and above group,and the level of LDH was higher than those in 3Dand above group(P<0.05).The levels ofRBCand Hb in O-Agroup were higher than those in O-Bgroup(P<0.05),the levels of TBIL,IBIL and LDH in o-ab group were lower than those in O-A group and O-B group(P<0.05),and the RBC count in o-ab group was higher than that in O-B group(P<0.05).There was no significant difference in hemolysis degree between children with different dat agglutination intensity(P>0.05).Conclusion the degree of anemia and hemolysis in children with HDN has nothing to do with gender differences and DAT agglutination intensity.It is closely related to the age of HDN diagnosis and the incidence of different maternal and infant blood groups.

关 键 词：ABO溶血症 溶血程度 贫血 

分 类 号：R722.18[医药卫生—儿科]