高胆红素血症患儿母婴ABO血型不合溶血病的发生特征以及临床诊断研究  

Study on the Occurrence Characteristics and Clinical Diagnosis of ABO Blood Type Incompatibility Hemolytic Disease in Mothers and Babies of Children with Hyperbilirubinemia

作　　者：王薇[1] 李争艳[1] 葛云萍[1] WANG Wei;LI Zhengyan;GE Yunping(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4期105-108,共4页Clinical Research

摘　　要：目的观察高胆红素血症患儿母婴ABO血型不合新生儿溶血病(HDN)的发生特征,并对其临床诊断价值进行研究。方法选取2022年5月至2023年5月济源市中心血站治疗的高胆红素血症患儿123例,根据其是否发生母婴ABO血型不合HDN分为溶血组(56例)和非溶血组(67例),记录溶血组患儿的母婴ABO血型组合及HDN阳性分布情况,比较两组患儿血液检测指标及免疫球蛋白G(IgG)抗体亚型水平,评估其诊断价值。结果溶血组患儿ABO血型母亲/新生儿血型以O/A型占比最高[29(51.79%)]。溶血患儿母亲IgG抗A/B抗体效价高于512的占比最高[22(39.29%)]。两组患儿血小板分布宽度及平均体积、直接胆红素、平均红细胞血红蛋白含量及体积无差异(P>0.05),溶血组的血红蛋白低于非溶血组,总胆红素、平均红细胞血红蛋白浓度比非溶血组高(P<0.05)。溶血组和非溶血组母亲的IgG2、IgG4水平无差异(P>0.05),IgG3水平低于非溶血组,IgG1高于非溶血组(P<0.05)。ROC曲线分析显示患儿血红蛋白、总胆红素、平均红细胞血红蛋白浓度、IgG1、IgG3水平对患儿溶血的诊断价值较高,AUC值分别为0.704、0.896、0.813、0.805、0.925。结论高胆红素血症患儿中,母婴ABO血型不合是导致新生儿溶血病的主要原因,且通过检测特定的血液生化指标和免疫蛋白G抗体水平可以有效诊断高胆红素血症患儿溶血病的发生。Objective To observe the occurrence characteristics of neonatal hemolytic disease(HDN)due to ABO blood type incompatibility in mothers and infants of children with hyperbilirubinemia and to study its clinical diagnostic value.Methods A total of 123 children with hyperbilirubinemia treated at Jiyuan Central Blood Station from May 2022 to May 2023 were selected.Based on the occurrence of ABO blood type incompatibility HDN,they were divided into a hemolysis group(56 cases)and a non-hemolysis group(67 cases).The ABO blood type combinations of mothers and infants in the hemolysis group and the distribution of HDN positivity were recorded.Blood test indicators and immunoglobulin G(IgG)antibody subtype levels were compared between the two groups to assess diagnostic value.Results In the hemolysis group,the mother/newborn ABO blood type combinations were predominantly O/A type[29(51.79%)].The proportion of mothers in the hemolysis group with an IgG anti-A/B antibody titer higher than 512 was also the highest[22(39.29%)].There were no differences in platelet distribution 106 Clinical Research,Apr.2025,Vol.33 No.04 width,mean platelet volume,direct bilirubin,mean corpuscular hemoglobin content,and volume between the two groups(P>0.05).However,the hemoglobin levels in the hemolysis group were lower than those in the non-hemolysis group,while total bilirubin and mean corpuscular hemoglobin concentration were higher in the hemolysis group(P<0.05).No differences were observed in the IgG2 and IgG4 levels between the mothers of the two groups(P>0.05);however,IgG3 levels were lower and IgG1 levels were higher in the hemolysis group compared to the non-hemolysis group(P<0.05).ROC curve analysis indicated that hemoglobin,total bilirubin,mean corpuscular hemoglobin concentration,IgG1,and IgG3 levels had high diagnostic value for hemolysis in children,with AUC values of 0.704,0.896,0.813,0.805,and 0.925,respectively.Conclusion In children with hyperbilirubinemia,maternal-infant ABO blood type incompatibility is a major cause of neona

关 键 词：高胆红素血症 ABO血型 新生儿溶血病 诊断价值 

分 类 号：R556.63[医药卫生—血液循环系统疾病]