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新生儿溶血病检查在重度高胆红素血症患儿诊疗中的意义

Significance of HDN detection for newborn with severe hyperbilirubinemia
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摘要 目的:探讨新生儿溶血病(HDN)在重度高胆红素血症患儿诊断治疗中的临床意义。方法:对300例重度高胆红素血症患儿进行HDN血型血清学检查,回顾性分析HDN结果与血清总胆红素(TSB)、日龄之间的关系。结果:300例重度高胆红素血症新生儿标本中,共检出ABO-HDN 134例(44.67%)、ABO以外HDN 20例(6.67%)、未检出HDN 146例(48.67%),3组日龄差异有统计学意义(P<0.01),TSB差异无统计学意义(P>0.05);母婴血型O/A型与O/B型其HDN检出率差异无统计学意义(P>0.05);重度、极重度、危险性高胆红素血症HDN检出率差异无统计学意义(P>0.05),TSB及日龄差异均有统计学意义(均P<0.01);HDN检出率随日龄增长呈下降趋势,其中日龄1~5 d呈快速下降趋势,5~9 d呈平稳趋势,9 d以上呈缓慢下降趋势,TSB随日龄增长呈先上升后下降趋势,于9.5 d龄处达到峰值,约为516μmol/L。结论:HDN结果与新生儿日龄密切相关,对重度高胆红素血症患儿病因的早期识别与诊断有较大临床意义,临床标本应尽快送检,以免错过最佳检测时机。 Objective:To discuss the clinical significance of hemolytic disease of newborn(HDN)in the diagnosis of newborn with severe hyperbilirubinemia.Method:HDN detection were conducted for 300 cases of newborn with severe hyperbilirubinemia,and retrospective analysis on the relationship between HDN results and total serum bilirubin(TSB),as well as age,was made.Result:In the specimens of 300 newborn with severe hyperbilirubinemia,20 were N-ABO-related HDN(6.67%),134 were ABO-related HDN(44.67%),and 146 were free from HDN(48.67%).Among the three groups,the difference of age was significant(P<0.01),while their TSB were nearly the same(P>0.05).There was no significant difference on the detection rates of HDN between cases of maternal/infant blood group O/A and O/B(P>0.05).The difference of HDN detection rates between cases with severe(n=103),extremely severe(n=116)and dangerous(n=81)hyperbilirubinemia was not statistically significant(P>0.05),but the differences of TSB and age between these three groups were statistically significant(P<0.01).The detection rate of HDN decreased with age,showed as a trend line with a rapid decline phase in 1-5 days,a steady phase in 5-9 days,and a slow decline phase 9 days later.Besides,TSB increased first and then decreased with age,reaching the peak level on day 9.5,the value was about 516μmol/L.Conclusion:HDN detection has a great clinical significance for the early identification and diagnosis of the cause of newborn with severe hyperbilirubinemia,we are convinced that there is a correlation between HDN detection results and the corresponding age of newborn.Clinical specimens should be detected as soon as possible,lest they miss the best time to receive inspections.
作者 任明 强文 江梦天 马梦迪 杨茹 沈钢 李刚 REN Ming;QIANG Wen;JIANG Mengtian;MA Mengdi;YANG Ru;SHEN Gang;LI Gang(Transfusion Research Department of Wuhan Blood Center,Wuhan,430030,China)
出处 《临床血液学杂志:输血与检验》 2019年第3期407-410,414共5页 Journal of Clinical Hematology
基金 武汉市卫生计生委科研计划资助项目(No:WX18C15).
关键词 新生儿溶血病 高胆红素血症 血清总胆红素 hemolytic disease of the newborn hyperbilirubinemia total serum bilirubin
作者简介 通信作者:李刚,E-mail:2256540990@qq.com
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