ABO血型不合溶血病与G6PD缺乏症致正常体重足月新生儿高胆红素血症的临床特征比较分析  

Comparative Analysis of the Clinical Characteristics of Hyperbilirubinemia in Normal Weight Full-Term Neonates Caused by ABO Incompatibility Hemolytic Disease and G6PD Deficiency

作　　者：樊永娜 FAN Yongna(Department of Clinical Laboratory,the People's Hospital of Qiannan,Duyun 558000,China)

机构地区：[1]黔南州人民医院检验科,都匀558000

出　　处：《中国医药指南》2024年第18期47-50,共4页Guide of China Medicine

摘　　要：目的比较正常体重足月新生儿以葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症和新生儿ABO血型不合溶血病(ABO-HDN)为致病因素导致新生儿高胆红素血症的临床特征的差异。方法选取2021年1月至2023年9月在我院因“新生儿高胆红素血症”住院治疗的正常体重足月新生儿148例为研究对象,根据诊断将其分为G6PD缺乏症组(96例)和ABO-HDN组(52例),对其性别、胎龄、出生体重、分娩方式、入院日龄、入院前黄疸出时间、生后24 h黄疸发生率、黄疸出现日龄、TBIL浓度峰值、IBIL浓度峰值、贫血发生率、住院治疗时间、急性胆红素脑病发生情况进行回顾性比较分析。结果ABO-HDN组比G6PD缺乏症组患儿出生后24 h黄疸率更高、出现黄疸的年龄更小、入院日龄更小、患儿入院前黄疸出现时间更短、贫血发生率更高(P<0.05);G6PD缺乏症组比ABO-HDN组患儿的TBIL浓度峰值、IBIL浓度峰值更高(P<0.05)。两组患儿住院治疗时间比较,差异无统计学意义(Z=-0.538,P>0.05)。G6PD缺乏症组有2例患儿出现急性胆红素脑病,ABO-HDN组未出现,患儿均治愈出院。结论G6PD缺乏症患儿发生黄疸时间与生理性黄疸时间重合,导致就诊延迟而发生更严重黄疸,甚至出现急性胆红素脑病;而ABO-HDN患儿黄疸出现时间早,治疗更及时,避免了不良后果的发生。Objective To compare the clinical characteristics of neonatal hyperbilirubinemia caused by glucose-6-phosphate dehydrogenase(G6PD)deficiency and neonatal ABO incompatibility hemolytic disease(ABO-HDN)in normal weight term neonates.Methods A total of 148 full-term neonates with normal weight who were hospitalized for neonatal hyperbilirubinemia in our hospital from January 2021 to September 2023 were selected as the study subjects,and were divided into G6PD deficiency group(96 cases)and ABO-HDN group(52 cases)according to diagnosis.The sex,the gestational age,the birth weight,the ways of delivery,the age of admission,the time of jaundice onset before admission,the jaundice rate of 24 hours after birth,the age at which jaundice occurred,the peak concentration of total bilirubin(TBIL),the peak concentration of indirect bilirubin(IBIL),the rate of anemia,the time of hospitalization and the occurrence of acute bilirubin encephalopathy were retrospectively analyzed.Results Compared with G6PD deficiency group,there were higher jaundice rate of 24 hours after birth,younger age of jaundice,younger age of admission,shorter time of jaundice onset before admission to the hospital,and higher rate of anemia in ABO-HDN group(P<0.05).The peak concentrations of TBIL and IBIL in G6PD deficiency group were higher than in ABO-HDN group(P<0.05).There was no statistical difference in hospitalization time between the two groups(Z=-0.538,P>0.05).There were 2 children who occurred acute bilirubin encephalopathy in G6PD deficiency group,but not in ABO-HDN group,and all the children were cured and discharged from hospital.Conclusions The time of jaundice in children with G6PD deficiency coincides with the time of physiologic jaundice,which leads to delayed treatment and more severe jaundice,and even acute bilirubin encephalopathy.However,the jaundice of ABO-HDN children appeared earlier,and the treatment was more timely to avoid the occurrence of adverse consequences.

关 键 词：葡萄糖-6-磷酸脱氢酶缺乏症 新生儿ABO血型不合溶血病 足月新生儿 新生儿高胆红素血症 

分 类 号：R556.63[医药卫生—血液循环系统疾病] R722[医药卫生—内科学]