摘要
目的了解ABO胎儿新生儿溶血病(hemolytic disease of fetus and newborn,HDFN)黄疸分度与多指标的相关性,对ABO HDFN做到精准诊断、及时治疗,严防后遗症发生。方法对2020年3月—2023年2月本院确诊的283名ABO HDFN患儿根据总胆红素值分为轻、中、重三类,分析比较患儿基本资料、相关检验指标、溶血三项试验凝集强度的差异。结果患儿黄疸不同分度中男性重度患儿占75%(12/16),与中度37.5%(57/152)比较,差异具有统计学意义(P<0.05);黄疸不同分度轻中重度皮测黄疸(额头)值(mg/dL)分别为(9.88±1.93)、(12.34±2.01)、(15.56±2.69),皮测黄疸(面部)值(mg/dL)分别为(10.25±2.27)、(13.28±2.32)、(15.99±2.86),皮测黄疸(胸部)值(mg/dL)分别为(9.67±2.16)、(12.51±2.11)、(15.33±2.36)),DBIL值(μmol/L)分别为(9.87±2.06)、(11.90±2.59)、(16.12±4.73),IBIL值(μmol/L)分别为(159.36±37.55)、(252.98±30.52)、(353.76±55.68),中度与轻度比较,重度与中度比较,重度与轻度比较,差异均具有统计学意义(P均<0.05);黄疸不同分度轻中重度患儿CK值(unit/L)分别为(664.15±498.26)、(500.51±451.63)、(402.63±224.27),轻度组与其余2组比较,差异具有统计学意义(P<0.05),黄疸不同分度轻中重度患儿溶血三项试验凝集强度比较,差异无统计学意义。结论根据ABO HDFN患儿性别、皮测黄疸、DBIL、IBIL、CK可预测患儿黄疸严重程度,进一步对ABO HDFN积极治疗,分级治疗有一定提示,从而避免患儿病情拖重导致后遗症的发生甚至威胁生命。
Objective To explore the correlation between the severity of jaundice in ABO hemolytic disease of fetus and newborn(HDFN)and multiple indicators,in order to achieve accurate diagnosis,timely treatment,and prevent complications in ABO HDFN.Methods From March 2020 to February 2023,a total of 283 ABO HDFN in our hospital were classified into mild,moderate and severe groups based on total bilirubin levels.The differences in basic data,relevant laboratory indicators and the agglutination intensity of the three hemolysis tests were analyzed and compared.Results In the severe group,75%(12/16)were male infants,which was significantly higher compared to 37.5%(57/152)in the moderate group(P<0.05).The values(mg/dL)of transcutaneous jaundice in the mild,moderate and severe groups were:forehead 9.88±1.93 vs 12.34±2.01 vs 15.56±2.69,face 10.25±2.27 vs 13.28±2.32 vs 15.99±2.86,chest 9.67±2.16 vs 12.51±2.11 vs 15.33±2.36,respectively.The values(μmol/L)of direct bilirubin(DBIL)and indirect bilirubin(IBIL)were 9.87±2.06 vs 11.90±2.59 vs16.12±4.73,and 159.36±37.55 vs 252.98±30.52 vs 353.76±55.68,respectively,and the differences between the mild,moderate and severe groups were statistically significant(all P<0.05).The creatine kinase(CK)values(unit/L)of mild,moderate and severe groups were 664.15±498.26 vs 500.51±451.63 vs 402.63±224.27,and the difference between the mild group and the other two groups was statistically significant(P<0.05).There was no statistically significant difference in the agglutination intensity of the three hemolysis tests among HDFN with different severity of jaundice.Conclusion Clinicians can predict the severity of jaundice in light of gender,transcutaneous jaundice,DBIL,IBIL and CK of ABO HDFN,for further and graded treatment,so as to avoid the sequelae or even life-threatening consequences caused by ABO HDFN.
作者
徐荣华
侯星羽
熊春花
邢亚萍
吉学林
许小峰
李平
XU Ronghua;HOU Xingyu;XIONG Chunhua;XING Yaping;JI Xuelin;XU Xiaofeng;LI Ping(Department of Blood Transfusion,Kunming 650011,China;Department of Pediatrics,Kunming 650011,China)
出处
《中国输血杂志》
CAS
2023年第8期693-696,共4页
Chinese Journal of Blood Transfusion
基金
云南省教育厅科学研究基金项目资助(2023Y0676)
云南省科技厅重大科技专项计划项目开放课题(202302AA310018-E-1)。
关键词
ABO胎儿新生儿溶血病
黄疸分度
相关指标
总胆红素
ABO hemolytic disease of fetus and newborn(HDFN)
jaundice severity
related indicators
