20例非ABO-HDFN血型血清学分析及临床干预结果比较

目的　探讨意外抗体致非ABO-胎儿/新生儿溶血病（non-ABO hemolytic disease of the fetus and newborn, non-ABO HDFN）血型血清学分析及临床干预结果比较，为临床准确诊治提供参考。方法　回顾性分析2015年1月~2020年8月期间新生儿科送检，陕西省血液中心血型参比室进行检测并最终证实的20例非ABO-HDFN病例，鉴定20例母亲血清及患儿红细胞放散液中的意外抗体及效价；并按照临床干预方式的不同，将患儿分为光疗组、光疗后换血组和光疗后输血组，采用Kruskal-Wallis检验比较三组之间平均住院天数的差异。结果　20例非ABO-HDFN涉及到4个血型系统的9种意外抗体。三组之间平均住院天数比较，输血组平均住院天数最高（15.8±6.94天），换血组次之（11.25±2.86天），光疗组最短（8.5±1.89天）,三组之间平均住院天数差异有统计学意义（χ2=8.046，P=0.018)。结论　血型血清学检测分析是提高由意外抗体致非ABO-HDFN重要检测手段，临床应根据检出抗体的特性及患儿的病情轻重来评估其风险，及时对患儿采取必要的干预手段，对改善患儿预后具有参考价值。

Comparison of Serological Analysis and Clinical Intervention Results of 20 Non-ABO-HDFN Serum Types

Objective　To explore the analysis of serological analysis and clinical intervention results of accidental antibody-to-non-ABO-HDFN, and to provide reference for clinical accuracy. Methods　Retrospective analysis of neonatal department delivery from January 2015 to August 2020, blood type reference room of Shaanxi Province Blood Center for testing and final confirmation of 20 cases of non-ABO-HDFN cases, identification of 20 cases of mother serum and children in red blood cell release fluid accidental antibodies and efficacy. According to the different clinical intervention methods, the children were divided into three groups of phototherapy group, phototherapy transfusion group and phototherapy transfusion group, and the difference of average hospital days between the tcompared by Kruskal-Wallis test. Results　Twenty cases of non-ABO fetal neonatal hemolysis involved 9 unexpected antibodies in 4 blood type systems. Compared with the average number of hospital days between the three groups, the blood transfusion group had the highest average number of hospital days (15.8±6.94day), the second-lowest number of blood transfusion groups (11.25±2.86day), and the shortest phototherapy group (8.5±1.89day), the difference in the average number of hospital days between the three groups was statistically significant (χ2=8.046, P = 0.018). Conclusion　Serological detection and analysis of blood type is an important detection method to improve the non-ABO-HDFN caused by accidental antibodies, and the clinical should evaluate the risk according to the characteristics of detected antibodies and the severity of the disease in the child, and take the necessary intervention measures for the child in time, which is of reference value to improve the prognosis of the child.