摘要
目的探讨新生儿ABO溶血病的早期诊断及治疗。方法回顾分析2003年4月～2006年4月收治的新生儿ABO溶血病287例。依据患儿出生后是否即刻行脐血溶血3项检查和是否静脉应用大剂量丙种球蛋白治疗分为4组：行脐血溶血3项检查者，分为常规Ⅰ组（23例）和丙种球蛋白Ⅰ组（丙球I组，92例）；未行脐血溶血3项检查者，分为常规Ⅱ组（43例）和丙球Ⅱ纽（129例）。分析4组基本状况（年龄、性别、出生体质量等），血清总胆红素（TB）、血红蛋白（Hb）水平。结果4组性别、胎龄、出生体质量、血型、黄疸出现时间、发生黄疸高峰时间、光疗持续时间、平均住院时间等均无显著性差异（Pa〉0．05）。与丙球Ⅰ组和常规Ⅰ组比较，丙球Ⅱ组和常规Ⅱ组入院日龄明显较大（P。〈0．01），TB水平明显增高（P。〈0．01）。与常规组比较，丙球组黄疸高峰值明显降低（Pa〈0．01）。人院时Hb水平，除丙球Ⅰ组偏低外（P〈0．01），余3组间均无显著性差异（Pa〉0．05）。住院1周后复查Hb，丙球Ⅰ组Hb水平降低程度较常规Ⅰ组小。结论脐血溶血3项检查对于新生儿ABO溶血病早期诊断具有重要价值；在常规治疗基础上，静脉应用大剂量丙种球蛋白必须早期（出生48h内）进行才能更为有效降低患儿胆红素水平和贫血程度。
Objective To explore the methods of early diagnosis and therapy on hemolytic disease of newborn with hemolytic. Methods According to whether the cord blood hemolytic 3 items check were made and intravenous immunoglobulin with higher dose was used, 287 cases of neonatal ABO hemolytic in our hospital from Apr. 2003 to Apr. 2006 were divided into 4 groups ： control group Ⅰ （ n = 23 ） and gammaglobulin therapy group Ⅰ （n = 92） （ cord blood hemolytic 3 items check were made） ;control group Ⅱ （n = 43 ） and gammaglobulin therapy group Ⅱ （n = 129 ） （ peripheral blood hemolytic 3 items check were not made）. Common clinical data （ age, sex, birth weight,et al. ） and the level of serum bilirubin and hemoglobin were analyzed. Results There were no significant differences of sex, gestation age, birth weight, blood type constituent ratio, jaundice emergence and apex time, phototherapy persistence time and average stay in 4 groups（ Pa 〉 0.05 ）. Compared with control group Ⅰ and gammaglobulin therapy group Ⅰ,age of hospital admission was older （Pa 〈0.01 ） , and the level of serum total bilirubin was higher （Pa 〈 0.01 ） in control group Ⅱ and gammaglobulin therapy group Ⅱ. Compared with control groups, the jaundice high - peak was lower in gammaglobulin therapy groups（Pa 〈0.01 ）. Compared with control group I , the hemoglobin level rechecked after 1 week in hospital declined tardily in gammaglobulin therapy group Ⅰ. Conclusions The cord blood hemolytic 3 items check play a role in early diagnosis of hemolytic disease of newborn with hemolytic. It has effection on decreasing the level of serum bilirubin and the degree of anaemia that intravenous immunoglobulin with higher dose is used in 48 hours after birth.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2007年第14期1055-1056,共2页
Journal of Applied Clinical Pediatrics
关键词
婴儿
新生
ABO血型系统
溶血病
脐血
infant, newborn
ABO blood - group system
hymolytic disease
cord blood
