常州地区Rh、MNS血型不合致新生儿溶血病的试验结果分析及治疗

目的分析常州地区Rh、MNS血型系统不规则抗体所致新生儿溶血病的抗体分布特点及治疗效果。方法对常州地区2013-2019年由不规则抗体引起的新生儿溶血病患儿溶血筛查试验结果及治疗效果进行回顾性分析。结果23例由不规则抗体导致的新生儿溶血病致病抗体来自Rh和MNS两个血型系统,其中由抗-E引起的溶血病13例,由抗-D引起的溶血病8例,由抗-M引起的溶血病2例。有7例患儿进行了换血治疗,换血治疗后患儿红细胞计数、血红蛋白水平升高,胆红素水平明显降低,差异有统计学意义(P<0.05)。结论目前常州地区抗-E是Rh血型系统新生儿溶血病中最常见的抗体,且患儿母亲均有多次妊娠史。为预防新生儿溶血病的发生,对有妊娠史和输血史的孕妇,要加强产前不规则抗体血清学检测,并合理制订个体诊疗及换血方案,这对重症新生儿溶血病患儿的救治具有重要意义。

Test results analysis and treatment of neonatal hemolytic disease caused by Rh,MNS blood type incompatibility in Changzhou area

Objective To analyze the distribution characteristics and treatment effects of neonatal hemolytic disease caused by irregular antibody of Rh,MNS blood type system in Changzhou area.Methods The hemolysis screening test results and treatment effects of neonatal hemolytic disease caused by irregular antibodies among children patients of neonatal hemolytic disease submitted in Changzhou area during 2013-2019 were retrospectively analyzed.Results Among 23 cases of neonatal hemolytic disease caused by irregular antibodies,the pathogenic antibodies were from Rh and MNS blood type systems.Among them,13 cases were anti-E caused hemolytic disease,8 cases were caused by anti-D and 2 cases were caused by anti-M.Seven cases conducted the exchange blood transfusion.The levels of RBC count and Hb after exchange blood transfusion treatment had increase and the bilirubin level significantly decreased(P<0.05).Conclusion The anti-E is the most common antibody in Rh neonatal hemolytic disease in Changzhou area at present,moreover the mothers have the history of multiple pregnancy.For preventing the occurrence of neonatal hemolytic disease,the pregnant women with pregnancy and blood transfusion history should strengthen the serologic detection of irregular antibody and rationally formulate the personalized diagnosis and treatment scheme and exchange blood transfusion scheme,which has an important significance to the treatment of severe neonatal hemolytic disease.