库存血G6PD活性降低对新生儿高胆红素血症换血治疗效果的影响

目的探讨新生儿高胆红素血症换血治疗时库存血G6PD活性降低对治疗效果的影响。方法根据换入的库存血的G6PD活性检测结果将56例接受换血治疗的高胆红素血症新生儿分为两组：库存血G6PD活性降低（G6PD-D）组与库存血G6PD活性正常（G6PD-N）组。比较换血后各时段（0、122、4 h）二组患儿的TSB水平及下降百分比,并对其换血后的光疗时间进行比较。结果与G6PD-N组比较,G6PD-D组患儿换血后的TSB水平下降较慢,换血12及24 h时TSB的下降百分比较小,换血后的光疗时间延长（P〈0.05）。结论高胆红素血症新生儿换血治疗时输入G6PD活性降低的库存血液将使换血后患儿的胆红素水平下降较慢,光疗时间明显延长,建议新生儿换血治疗前对库存血液进行G6PD活性筛查实验。

Impact of Glucose 6 - Phosphate Dehydrogenase Activity Deficiency of Bank Blood on Therapeutic Efficacy of Exchange Transfusion in Neonatal Hyperbilirubinemia

Objective To explore the influence of glucose 6-phosphate dehydrogenase activity deficiency of bank blood on therapeutic effect of exchange transfusion in neonates with hyperbilirubinemia. Methods Fifty-six neonates with hyperbilirubinemia who received exchange transfusion were divided into G6PD-normal group(G6PD-N) and G6PD-deficiency group(G6PD-D) according to the G6PD activity of bank blood.Total serum bilirubin(TSB) level and the drop percentage of it at 0 hour,12 hours and 24 hours after exchange transfusion in two groups were compared.The mean duration of phototherapy was adopted to evaluate the efficacy of exchange transfusion with G6PD-deficient blood. Results Compared with the neonates in G6PD-N group,the neonates in G6PD-D group had a significantly lesser drop in TSB and the drop percentage at 12 and 24 hours after exchange transfusion.The duration of phototherapy for G6PD-D group was also significantly longer than that of G6PD-N group(P<0.05). Conclusions In neonates with hyperbilirubinemia,exchange transfusion with G6PD-deficient blood would have a lesser drop of TSB and a significantly longer duration of phototherapy.The results suggest that bank blood should be screened for G6PD activity before being used for exchange transfusion in neonates.