ABO溶血足月新生儿C反应蛋白表达水平及临床意义  

The expression level and clinical significance of C-reactive protein in full-term newborns with ABO hemolytic disease

作　　者：冉从玲 吴丕六 何媛媛 邓钦引 李静 吴静 RAN Congling;WU Piliu;HE Yuanyuan;DENG Qinyin;LI Jing;WU Jing(Department of Neonatology,Bishan District Maternal and Child Health Care Hospital,Chongqing 402760,China)

机构地区：[1]重庆市璧山区妇幼保健院新生儿科,重庆402760

出　　处：《现代医药卫生》2024年第11期1892-1895,共4页Journal of Modern Medicine & Health

基　　金：重庆市璧山区科技局2022年第二批社会民生领域科技计划项目(BSKJ0024)。

摘　　要：目的探讨C反应蛋白(CRP)在同族免疫性溶血病(ABO溶血)足月新生儿中的表达水平及临床意义。方法回顾性纳入2020年1月至2022年12月该院新生儿监护中心住院的高胆红素血症足月新生患儿为研究对象,分为ABO溶血组(溶血组)与非溶血性高胆红素血症组(非溶血组),对比分析2组患儿的临床资料、CRP值及CRP异常率,以及使用抗生素情况。结果共纳入患儿662例,其中溶血组350例,非溶血组312例。溶血组患儿平均入院日龄、入院时经皮黄疸值低于非溶血组,差异均有统计学意义(P<0.05)。溶血组患儿平均住院时间、入院时CRP水平及异常检出率高于非溶血组,差异均有统计学意义(P<0.05)。溶血组患儿异常的CRP水平为15.06(11.81,22.20)mg/L。溶血组患儿抗菌药物使用率(11.1%)高于非溶血组(4.2%),差异有统计学意义(P<0.05)。溶血组中未使用抗菌药物的12例患儿升高的CRP降至正常水平所需平均时间为23.00(19.75,36.75)h。结论CRP表达水平在ABO溶血足月新生儿中有一过性升高,降至正常所需的时间平均在23 h左右。不建议合并CRP水平升高的溶血患儿积极使用抗生素,应动态监测并结合多项炎症指标及临床表现综合决策。Objective To investigate the expression level and clinical significance of C-reactive protein(CRP)in full-term newborns with ABO hemolytic disease.Methods The full-term newborns with hyperbilirubinemia who were hospitalized in the neonatal care center from January 2020 to December 2022 were retrospectively included as the research objects.They were divided into the ABO hemolytic group and the non-hemolytic hyperbilirubinemia group(the non-hemolytic group).The clinical data,CRP values,CRP abnormal rate,and the use of antibiotics were compared between the two groups.Results A total of 662 cases were included,including 350 cases in the hemolytic group and 312 cases in the non-hemolytic group.The average age of admission and the value of percutaneous jaundice at admission in the hemolytic group were significantly lower than those in the non-hemolytic group(P<0.05).The average hospitalization time,CRP level on admission and the abnormal detection rate of CRP in the hemolytic group were higher than those in the non-hemolytic group,and the differences were statistically significant(P<0.05).The abnormal CRP level in the hemolytic group was 15.06(11.81,22.20)mg/L.The utilization rate of antibiotics in the hemolytic group(11.1%)was higher than that in the non-hemolytic group(4.2%),and the difference was statistically significant(P<0.05).In the hemolytic group,the average time for the increased CRP to drop to the normal level was 23.00(19.75,36.75)h.Conclusion The expression level of CRP is transiently increased in full-term neonates with ABO hemolysis disease,and the average time required to return to normal is about 23 hours.It is not recommended to actively use antibiotics in hemolytic children with elevated CRP levels.It should be dynamically monitored and combined with multiple inflammatory indicators and clinical manifestations to make decisions on whether to make comprehensive decisions.

关 键 词：足月分娩 新生儿 ABO溶血病 C反应蛋白 抗菌药物 

分 类 号：R722.18[医药卫生—儿科]