新生儿ABO溶血病并红细胞葡萄糖-6-磷酸脱氢酶缺乏症临床对比分析

目的 探讨新生儿ABO溶血病、红细胞葡萄糖-6-磷酸脱氢酶(G-6-PD)缺乏症及两者合并患儿的临床特点.方法 对160例新生儿ABO溶血病(ABO组)、219例G-6-PD缺乏症(G6PD组)、52例新生儿ABO溶血病并G-6-PD缺乏症(ABO+G617D组)3组临床相关指标进行对比分析.结果 G6PD组血红蛋白(159.7±24.9)g/L]高于ABO组(150.2±23.0)g/L]和ABO+G6PD组(149.2±22.8)g/L],差异均有统计学意义(P均<0.01);血清总胆红紊高于ABO组(419.0±152.9)μmol/L与(355.4±113.2)μmol/L],差异有统计学意义(P<0.01);黄疸消退时间较ABO组长(9.4±2.3)d与(8.1±2.2)d],差异有统计学意义(P<0.01).ABO+G6PD组黄疸消退时间(12.0±2.7)d]、光疗时间(43.2±16.0)h]、光疗次数(3.5±1.2)次]均长或多于ABO组(8.1.4-2.2)d、(36.1 4-15.9)h、(2.6±1.2)次]及其G6PD组(9.4±2.3)d、(37.6±17.3)h、(2.8 4-1.3)次],差异均有统计学意义(P均<0.05).G6PD组胆红素脑病(16.O%)、低钙血症发生率(32.9%)高于ABO组(6.9%、20.0%),差异有统计学意义(P<0.05);而其贫血发生率(23.3%)则低于ABO组(40.0%)及其ABO+G6PD组(51.9%),差异有统计学意义(P<0.01).结论 新生儿ABO溶血病并G-6-PD缺乏症时,黄疸出现时间、黄疸程度、胆红素脑病发生率与新生儿ABO溶血病、G-6-PD缺乏症差异无显著性,但黄疸消退时间更长,黄疸更易反复.G-6-PD缺乏症与新生儿ABO溶血痛相比,黄疸程度更重,退黄时间更长,更易发生胆红素脑病,但贫血发生率更低.

Clinical analysis of ABO hemolytic disease in newborn with giucose-6-phosphate dehydrogenase deficiency.

Objective To explore the clinical features of ABO hemolytic disease in newboms,red blood cell glucose-6-phosphate dehydrogenase(G-6-PD) deficiency and the combined. Methods In the study, 160 cases of ABO hemolytic disease in newborn (ABO group) ,219 cases of G-6-PD deficiency(G6PD group) ,52 cases of the combined(ABO + G6PD group). The three groups were analyzed. Results The hemoglobin in the G6PD group ( (159. 7 ± 24.9) g/L) was significantly higher than in the ABO group ((150. 2 ± 23.0) g/L) and ABO + G6PD group( (149. 2 ±22. 8) g/L) (P < 0. 01). TBIL in the G6PD group ( (419. 0 ± 152. 9)μmol/L) was significantly higher than that in the ABO group ( ( 355. 4 ± 113. 2 )μmol/L) ( P < 0. 01). The Jaundice dissipated time in the G6PD group were significantly longer than ABO group ( ( 9.4 ± 2. 3) d vs. ( 8. 2 ± 2. 2 ) d) ( P < 0. 01 ) . In the ABO + G6PD group, the Jaundice dissipated time, time of phototherapy and number of phototherapy was (12. 0 ± 2. 7)d,(43. 2±16. 0)h and (3.5 ± 1. 2) times, which was significantly longer (or more) than those of the ABO group ((8. 1 ±2.2)d,(36. 1 ±15.9)h and (2. 6 ±1. 2)times) and G6PD group( (9.4 ±2. 3)d,(37. 6 ± 17. 3)h and (2. 8 ± 1. 3) times) (P<0. 05). The incidence of the bilirubin encephalopathy, hypocalcemia rate in the G6PD group (16. 0% ,32.9% ) were significantly higher than those in the ABO group(6. 9% and 20.0% ) (P <0. 05 ) . However, the incidence of anemia (23. 3% ) in the G6PD group was significantly lower than that in the ABO group (40. 0% ) and ABO + G6PD group (51.9%) ( P < 0. 01) . Conclusions In the newborns with ABO hemolytic disease and G-6-PD deficiency,the time jaundice appear,the degree of jaundice,bilirubin encephalopathy rate were not significantly different from those in the ABO hemolytic disease and G-6-PD group, but the jaundice persisted longer,and more easily repeated. Compared to the neonatal ABO hemolytic disease, the degree of jaundice, jaundice persisted longer in the G-6-PD deficiency,bilirubin encephalopathy is more likely to occur,whereas the incidence of anemia is much lower.