ABO外不规则血型抗体导致新生儿溶血病的病例临床和抗体分布特征  

Clinical and Antibody Distribution Characteristics of Neonatal Hemolytic Disease Caused by Non-ABO Irregular Blood Type Antibodies

作　　者：王薇[1] 葛云萍[1] 李争艳[1] WANG Wei;GE Yunping;LI Zhengyan(Blood Supply Department,Jiyuan Central Blood Station,Jiyuan Henan 459000,China)

机构地区：[1]济源市中心血站供血库,河南济源459000

出　　处：《临床研究》2025年第3期11-14,共4页Clinical Research

摘　　要：目的探讨ABO外不规则血型抗体导致新生儿溶血病(HDN)的病例临床和抗体分布特征。方法选取自济源市人民医院2019年1月至2024年1月收治的母婴血型不合疑似发生ABO外不规则血型抗体阳性新生儿溶血病160例,根据新生儿溶血病诊断标准分为溶血组(80例),非溶血组(80例),比较两组的临床特征(经皮测胆值、送检日龄、黄疸出现时龄)、血清学指标[白细胞(WBC)、血红蛋白(Hb)、红细胞(RBC)、血小板计数(PLT)、血细胞比容(HCT)、网织红细胞百分比]、肝功能指标[总胆红素/白蛋白比值(B/A)、血清直接胆红素(DBiL)、总胆红素(TBiL)、间接胆红素(IBiL)、和白蛋白(ALB)、总胆汁酸(TBA)]水平及溶血组抗体特异性分布情况。结果溶血组的经皮测胆值高于非溶血组,黄疸出现时龄低于非溶血组,送检日龄≤3 d多于非溶血组(P<0.05)。溶血组的Hb、RBC、HCT水平低于非溶血组,网织红细胞百分比高于非溶血组(P<0.05);两组的WBC、PLT水平比较,差异无统计学意义(P>0.05)。溶血组的B/A、TBiL、IBiL水平高于非溶血组(P<0.05);两组的DBiL、ALB、TBA水平比较,差异无统计学意义(P>0.05)。溶血组的Rh系统的抗体占比最高,其中抗-D抗体占比最高(47.50%),其次为抗-E抗体(17.50%);MNS系统抗体占比居中(抗-S为3.75%,抗-M为6.25%);Kidd系统抗体分布最低,抗-JKa占比1.25%,抗-JKb占比为2.50%。结论新生儿溶血病黄疸出现早,经皮测胆值较高,血清学中的Hb、RBC、HCT明显降低,网织红细胞百分比升高,肝功能指标水平中B/A、TBiL、IBiL水平较高,以Rh系统抗-D抗体占比最高。Objective To explore the clinical and antibody distribution characteristics of cases of neonatal hemolytic disease of newborn(HDN)caused by non-ABO irregular blood type antibodies.Methods A total of 160 cases of suspected neonatal hemolytic disease due to maternal-fetal blood group incompatibility and positive for non-ABO irregular blood type antibodies,admitted to Jiyuan People's Hospital from January 2019 to January 2024,were selected.Based on HDN diagnostic criteria,patients were divided into a hemolysis group(80 cases)and a non-hemolysis group(80 cases).Clinical features(bilirubin levels on transcutaneous measurement,age at examination,age at jaundice onset),serological indicators[white blood cell count(WBC),hemoglobin(Hb),red blood cells(RBC),platelet count(PLT),hematocrit(HCT),and reticulocyte percentage],liver function indicators[total bilirubin/albumin ratio(B/A),serum direct bilirubin(DBiL),total bilirubin(TBiL),indirect bilirubin(IBiL),albumin(ALB),and total bile acid(TBA)]levels,and the specific distribution of antibodies in the hemolysis group were compared.Results The transcutaneous bilirubin levels in the hemolysis group were higher than those in the non-hemolysis group,with a lower age of jaundice onset and a higher proportion of patients with age≤3 days at examination(P<0.05).The hemolysis group had lower Hb,RBC,and HCT levels,and a higher reticulocyte percentage compared to the non-hemolysis group(P<0.05).There was no statistically significant difference in WBC and PLT levels between the two groups(P>0.05).The B/A,TBiL,and IBiL levels in the hemolysis group were higher than those in the non-hemolysis group(P<0.05);however,there were no significant differences in DBiL,ALB,and TBA levels between the two groups(P>0.05).The Rh system antibodies had the highest proportion in the hemolysis group,with anti-D antibodies being the most prevalent(47.50%),followed by anti-E antibodies(17.50%).MNS system antibodies showed moderate distribution(anti-S at 3.75%,anti-M at 6.25%),while Kidd system antibodies h

关 键 词：ABO外不规则血型抗体 新生儿溶血病 临床特征 抗体分布 

分 类 号：R725.5[医药卫生—儿科]