243例母婴血型不合致新生儿溶血病临床分析

目的为新生儿溶血病（HDN）的诊治提供直接依据。方法按有关方法分别进行ABO及Rh血型鉴定、直接抗人球蛋白试验、血清游离抗体及放散液抗体检测。结果在416例临床疑为新生儿溶血病患者中,证实由血型抗原不合引起的新生儿溶血病者243例（58.65%）,其中ABO-HDN242例（99.59%）,Rh-HDN1例（0.41%）。在被证实为ABO-HDN的242例患儿中,A型103例,占42.56%;B型139例,占57.44%。ABO-HDN患儿A型与B型分布率经卡方分析,χ2=3.1157,P=0.0775,差异无统计学意义。结论本地区因血型抗原不合引起的新生儿溶血病中,以ABO-HDN多见;＂三项试验＂中放散液抗体试验敏感度最高,是判定新生儿溶血病最有力的依据。

The clinical analysis of 243 cases of hemolytic disease of newborn caused by maternal-fetal blood type incompatibility

Objective To provide reference for the diagnosis and treatment of hemolytic disease of newborn.Methods The major detecting methods included the identification of Identifying ABO and Rh blood type,direct coombs＇ test,serum free antibodies test and antibodies dispersion test.Results In 416 case doubted as HDN,243 cases of HDN（58.41%）caused by maternal-fetal blood type incompatibility were identified,thereinto,242 cases belonged to ABO-HDN（99.59%）and 1 case belonged to Rh-HDN（0.41%）.In those ABO-HDN cases,103 cases（42.56%） were A blood type and 139 cases（57.44%）were B blood type.The rate of the distributions of A blood type and B blood type in ABO-HDN case had no statistically significant difference（χ2=3.1157,P=0.0775）.Conclusion A majority of cases of HDN which caused by maternal-fetal blood type incompatibility is ABO-HDN.Antibodies dispersion test is the most sensitive and is the most effectual method in the three kind of HDN test.