1 139例不同血型与ABO新生儿溶血病的相关性分析

Analysis of association between 1 139 cases of different blood types and ABO hemolytic disease of the newborn

摘要

目的 探讨不同血型新生儿ABO溶血病的影响因素,为新生儿溶血病的预防和治疗提供参考和指导。方法 回顾分析2017年1月至2024年12月于我院新生儿科就诊的1 139例ABO溶血病患儿,按母婴血型不合分为OA组和OB组,其中OA组686例,OB组453例。应用SPSS 29.0软件统计分析相关临床资料。结果 两组患儿一般情况分析中,OB组入院时龄(Z=-3.225)、头胎出生比例(χ²=9.937)均低于OA组,差异有统计学意义(P<0.05)。性别、分娩方式、喂养方式、胎龄、出生体重没有统计学差异(P>0.05)。母亲相关情况分析中,OA组胎膜早破(χ²=4.602)占比更高,差异具有统计学意义(P<0.05)。妊娠期糖尿病、妊娠期高血压、甲状腺异常、胆淤、贫血、肝功异常、B族链球菌感染、血小板异常、试管婴儿(IVF-ET)技术应用等方面均无统计学差异(P>0.05)。在小时胆红素列表图中,OB组高危区占比显著高于OA组,OA组低危区和中低危区占比高于OB组,差异有统计学意义(χ²=15.678、10.026、7.160,P<0.05);两组患儿中-高危区占比无统计学差异(P>0.05)。两组患儿溶血参数比较中,OA组直接抗人球蛋白试验阳性率(χ²=24.906)、入院时血红蛋白浓度(t=2.184)高于OB组(P<0.05),中性粒细胞百分率(Z=-4.621)低于OB组。游离试验阳性率、放散试验阳性率、血小板计数、血清总胆红素没有统计学差异(P>0.05)。OB组人免疫球蛋白使用比例(χ²=14.895)及光疗时长(Z=-3.900)高于OA组(P<0.05),差异有统计学意义。输血和换血则没有统计学差异(P>0.05)。结论 OB组较OA组溶血程度更重,免疫球蛋白输注率更高,光疗时间更长。

Abstract

Objective To explore the influencing factors of ABO hemolytic disease in newborns with different blood types,and to provide reference and guidance for the prevention and treatment of neonatal hemolytic disease. Methods A retrospective analysis was conducted on 1,139 cases of ABO hemolytic disease in newborns admitted to our hospital􀆳s neonatology department from January 2017 to December 2024.Patients were divided into OA group (686 cases) and OB group (453 cases) based on maternal-fetal blood type incompatibility.SPSS 29.0 software was used for statistical analysis of clinical data. Results In general characteristics comparison,the OB group had a significantly lower admission age (Z=-3.225) and proportion of firstborns (χ ²=9.937) compared to the OA group,with statistically significant differences (P<0.05).No significant differences were observed in gender,mode of delivery,feeding method,gestational age,or birth weight (P>0.05).Regarding maternal conditions,the OA group showed a higher rate of premature rupture of membranes (χ ²=4.602),which was statistically significant (P<0.05).There were no significant differences between the two groups regarding gestational diabetes,gestational hypertension,thyroid dysfunction,cholestasis,anemia,abnormal liver function,Group B streptococcus infection,platelet abnormalities,or use of in vitro fertilization-embryo transfer (IVF-ET) technology (P>0.05).In the hour-specific bilirubin chart,the OB group had a significantly higher proportion of high-risk zones compared to the OA group,while the OA group had higher proportions in low-risk and moderate-low-risk zones;these differences were statistically significant (χ ²=15.678,10.026 and 7.160,respectively,P<0.05).However,there was no significant difference in the proportion of medium-to-high risk zones between the two groups (P>0.05).Comparing hemolysis parameters,the OA group had a higher direct antiglobulin test positivity rate (χ ²=24.906) and higher hemoglobin concentration at admission (t=2.184) than the OB group (P<0.05),but a lower percentage of neutrophils (Z=-4.621).No significant differences were found in free antibody test positivity,elution test positivity,platelet count,or total serum bilirubin levels (P>0.05).The OB group had a higher rate of intravenous immunoglobulin use (χ ²=14.895) and longer phototherapy duration (Z=-3.900) than the OA group (P<0.05),indicating statistically significant differences.However,no significant differences were observed in transfusion or exchange transfusion rates (P>0.05). Conclusion The OB group exhibited more severe hemolysis,higher immunoglobulin infusion rates,and longer phototherapy durations compared to the OA group.

关键词

ABO血型不合 / 新生儿溶血病 / 新生儿高胆红素血症 / 病情程度

Key words

ABO incompatibility / hemolytic disease of the newborn / hyperbilirubinemia of newborn / disease severity

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