目的 回顾性分析474例高胆红素血症新生儿的临床资料,探讨ABO胎儿新生儿溶血病(hemolytic disease of the fetus and newborn, ABO-HDFN)所致高胆红素血症的临床特征及蓝光治疗影响因素。方法 本研究纳入2019年1月至2023年1月期间在兰...目的 回顾性分析474例高胆红素血症新生儿的临床资料,探讨ABO胎儿新生儿溶血病(hemolytic disease of the fetus and newborn, ABO-HDFN)所致高胆红素血症的临床特征及蓝光治疗影响因素。方法 本研究纳入2019年1月至2023年1月期间在兰州大学第一医院接受治疗的474例高胆红素血症新生儿作为研究对象。所有患儿均接受血型鉴定及新生儿溶血三项试验。收集并分析其基线临床资料。根据溶血三项试验结果,将患儿分为溶血性黄疸组和非溶血性黄疸组。对2组患儿的血红蛋白水平、住院时间及蓝光治疗持续时间等临床指标进行比较分析。同时,采用多元线性回归模型探讨影响蓝光治疗时间的相关临床因素。结果 474例高胆红素血症新生儿中,354例确诊为ABO-HDFN(溶血病组),120例未发生ABO-HDFN(非溶血病组)。A型新生儿中ABO-HDFN发生率(55.93%,198/354)高于B型新生儿(44.07%,156/354),差异有统计学意义(P<0.05)。此外,二胎及以上新生儿ABO-HDFN发生率(81.56%,146/179)高于首胎新生儿(70.51%,208/295),差异有统计学意义(P<0.05)。溶血病组患儿的血红蛋白水平(170.67±21.86)g/L低于非溶血病组(178.99±22.05)g/L(P<0.001),红细胞计数(4.66±0.63)×10^(12)/L低于非溶血病组(4.89±0.59)×10^(12)/L(P<0.05),红细胞压积(50.05±6.56)%低于非溶血病组(52.61±6.75)%(P<0.05)。溶血病组患儿的住院天数[6(5,9)d]、蓝光治疗时间[62(38,84.25)h]及黄疸发病次数[9(7,13)次]均高于非溶血病组[住院天数6(4,8)d、蓝光治疗时间53(34.25,64.77)h、黄疸发病次数8(6,12)次],差异均有统计学意义(P值均<0.05)。回归分析显示,游离抗体试验阳性及胎次(二胎及以上)是蓝光治疗时间延长的独立危险因素(P<0.05)。结论 ABO血型不合是新生儿溶血病的主要病因,应对母亲为O型、新生儿为A型者,加强对该人群胆红素水平的动态监测。多次妊娠增加了同种免疫性溶血风险,临床应针对二胎及以上新生儿缩短胆红素监测间隔,并在必要时开展产前干预措施。同时,应重视血红蛋白水平、红细胞计数等指标的变化对溶血性贫血及胆红素升高的预警作用。展开更多
[Objective] The research aimed to enhance culture efficiencies of oocyte and embryo of goat in vitro and to explore serum-free culture system in vitro.[Method] At present,the conventional solutions of oocyte maturatio...[Objective] The research aimed to enhance culture efficiencies of oocyte and embryo of goat in vitro and to explore serum-free culture system in vitro.[Method] At present,the conventional solutions of oocyte maturation and embryo development in vitro were always added into 1% ITS(Insulin-transferrin-selenium) or using 1% ITS to replace FBS in 2 kinds culture solutions for conducting in vitro cultures of goat oocyte and parthenogenetic embryo.The influences of ITS on their developments were detected.[Result] ITS in maturation liquid of oocytes could not increase oocytes maturation rate but significantly increased blastocyst rate (58.06% vs. 48.19%)of parthenogenetic embryo.If FBS in maturation liquid of oocytes was replaced by ITS, the maturation rate, cleavage rate and blastocyst rate were basically unchanged.Adding ITS into embryo medium could increase blastocyst rate (68.30% vs. 56.82%)of parthenogenetic embryo of goat.If FBS in embryo medium was replaced by ITS,the cleavage rate didn’t change basically,while the blastocyst rate in ITS was obviously lower than that in FBS group(42.33% vs.56.82%).[Conclusion] ITS could promote maturation of oocyte in vitro and early embryonic development, in addition,ITS could replace serum in maturation medium of oocyte as serum-free culture system for conducting relevant researches.展开更多
文摘目的 回顾性分析474例高胆红素血症新生儿的临床资料,探讨ABO胎儿新生儿溶血病(hemolytic disease of the fetus and newborn, ABO-HDFN)所致高胆红素血症的临床特征及蓝光治疗影响因素。方法 本研究纳入2019年1月至2023年1月期间在兰州大学第一医院接受治疗的474例高胆红素血症新生儿作为研究对象。所有患儿均接受血型鉴定及新生儿溶血三项试验。收集并分析其基线临床资料。根据溶血三项试验结果,将患儿分为溶血性黄疸组和非溶血性黄疸组。对2组患儿的血红蛋白水平、住院时间及蓝光治疗持续时间等临床指标进行比较分析。同时,采用多元线性回归模型探讨影响蓝光治疗时间的相关临床因素。结果 474例高胆红素血症新生儿中,354例确诊为ABO-HDFN(溶血病组),120例未发生ABO-HDFN(非溶血病组)。A型新生儿中ABO-HDFN发生率(55.93%,198/354)高于B型新生儿(44.07%,156/354),差异有统计学意义(P<0.05)。此外,二胎及以上新生儿ABO-HDFN发生率(81.56%,146/179)高于首胎新生儿(70.51%,208/295),差异有统计学意义(P<0.05)。溶血病组患儿的血红蛋白水平(170.67±21.86)g/L低于非溶血病组(178.99±22.05)g/L(P<0.001),红细胞计数(4.66±0.63)×10^(12)/L低于非溶血病组(4.89±0.59)×10^(12)/L(P<0.05),红细胞压积(50.05±6.56)%低于非溶血病组(52.61±6.75)%(P<0.05)。溶血病组患儿的住院天数[6(5,9)d]、蓝光治疗时间[62(38,84.25)h]及黄疸发病次数[9(7,13)次]均高于非溶血病组[住院天数6(4,8)d、蓝光治疗时间53(34.25,64.77)h、黄疸发病次数8(6,12)次],差异均有统计学意义(P值均<0.05)。回归分析显示,游离抗体试验阳性及胎次(二胎及以上)是蓝光治疗时间延长的独立危险因素(P<0.05)。结论 ABO血型不合是新生儿溶血病的主要病因,应对母亲为O型、新生儿为A型者,加强对该人群胆红素水平的动态监测。多次妊娠增加了同种免疫性溶血风险,临床应针对二胎及以上新生儿缩短胆红素监测间隔,并在必要时开展产前干预措施。同时,应重视血红蛋白水平、红细胞计数等指标的变化对溶血性贫血及胆红素升高的预警作用。
文摘[Objective] The research aimed to enhance culture efficiencies of oocyte and embryo of goat in vitro and to explore serum-free culture system in vitro.[Method] At present,the conventional solutions of oocyte maturation and embryo development in vitro were always added into 1% ITS(Insulin-transferrin-selenium) or using 1% ITS to replace FBS in 2 kinds culture solutions for conducting in vitro cultures of goat oocyte and parthenogenetic embryo.The influences of ITS on their developments were detected.[Result] ITS in maturation liquid of oocytes could not increase oocytes maturation rate but significantly increased blastocyst rate (58.06% vs. 48.19%)of parthenogenetic embryo.If FBS in maturation liquid of oocytes was replaced by ITS, the maturation rate, cleavage rate and blastocyst rate were basically unchanged.Adding ITS into embryo medium could increase blastocyst rate (68.30% vs. 56.82%)of parthenogenetic embryo of goat.If FBS in embryo medium was replaced by ITS,the cleavage rate didn’t change basically,while the blastocyst rate in ITS was obviously lower than that in FBS group(42.33% vs.56.82%).[Conclusion] ITS could promote maturation of oocyte in vitro and early embryonic development, in addition,ITS could replace serum in maturation medium of oocyte as serum-free culture system for conducting relevant researches.
