摘要
目的探讨Rh新生儿溶血病抗体分布特征及换血治疗策略。方法对15例来本院就诊Rh新生儿溶血病患儿及其母亲进行ABO血型鉴定、Rhxinshenger抗原表型鉴定,对患儿进行直接抗人球蛋白试验、游离抗体试验、抗体释放试验及抗体性质鉴定。比较重症组和轻微组患儿入院时年龄及胆红素峰值是否存在差异,并对换血治疗的患儿进行换血疗效评价。结果 15例Rh新生儿溶血病中抗-D10例(66. 67%),抗-E 3例(20. 00%),抗-c E、抗-C例、抗-E合并Jka各1例(6. 67%)。重症组和轻微组患儿入院年龄无明显差异(P>0. 05),重症组胆红素水平高于轻微组,差异有统计学意义(P<0. 05)。此外,7例重症组患儿进行了换血治疗,换血率43. 75%,换血治疗后胆红素明显降低。结论抗-D和抗-E是Rh新生儿溶血病中最常见的抗体。常规开展产前Rh溶血病血清学检测并制定个体化的诊疗及换血方案,对重症Rh新生儿溶血病的救治具有重要意义。
Objective To investigate the characteristics of irregular antibody and the strategies of exchange transfusion on the newborn with hemolytic disease caused by Rh antibodies(Rh HDN). Methods ABO blood group identification,Rh phenotype identification and irregular antibody screening were performed on 15 newborns and their mothers who came to our hospital for Rh HDN. Direct antiglobulin test,free antibody test,antibody release test and further antibody identification were conducted for the newborns. The differences in age and bilirubin of the newborns between the sever group and the mild group were compared,and the effect was evaluated after exchange transfusion. Results Among the 15 cases of Rh HDN,10 cases(66. 67%) were anti-D,3(20. 00%) were anti-E,1(6. 67%) was anti-cE,anti-C and 1(6. 67%) was anti-E combined with Jka. There was no significant difference in admission age between the severe group and the mild group(P>0. 05),but the bilirubin level in the severe group was higher than that in the mild group with statistically significant difference(P <0. 05). Moreover,7 cases of the severe group received exchange transfusion with an exchange transfusion rate of 43. 75%,and a significant reduction in bilirubin after exchange transfusion treatment was observed. Conclusion The main antibodies of Rh HDN are anti-D and anti-E,and severe Rh HDN may threaten the lives of the newborns. Therefore,the routine detection of HDN with a personalized diagnosis,treatment and exchange transfusion plan are of great significance for the treatment of severe Rh HDN.
作者
马峰
岳彦伟
吴继博
万春晶
徐华
王宝燕
MA Feng;YUE Yanwei;WU Jibo;WAN Chunjing;XU Hua;WANG Baoyan(Department of blood transfusion,the First Affiliated Hospital of Xi'an Jiao Tong University,Xi'an 710061,China;Shaanxi Blood Centre)
出处
《中国输血杂志》
CAS
2018年第11期1230-1232,共3页
Chinese Journal of Blood Transfusion
关键词
RH血型
新生儿溶血病
换血治疗
不规则抗体
Rh blood group
Hemolytic Disease of the Newborn
exchange transfusion
irregular antibody
