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孕期血型免疫的预防、诊断与治疗

[Prevention, diagnosis and treatment of blood group immunization during pregnancy].

作者信息

van Aken W G, Christiaens G C

机构信息

Centraal Laboratorium voor de Bloedtransfusiedienst/Sanquin, Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 1999 Dec 11;143(50):2507-10.

Abstract

In the Netherlands last year two important policy changes were introduced to prevent haemolytic disease of the newborn: antenatal administration of anti RhD immunoglobulin and screening for antibodies against irregular erythrocyte antigens in all pregnant women. As the predictive value of such antibodies for the detection of hemolytic disease of the newborn is limited, it is uncertain if this measure is really cost-effective. Because blood transfusion is the most important probable cause of the immunization, and because of the clinical severity of anti-K antibodies, it is advised to give exclusively K negative blood to girls and women under the age of 45 years. In addition there is a need for a uniform protocol to deal with women who have been exposed to immunization.

摘要

去年在荷兰实施了两项重要的政策变革,以预防新生儿溶血病:对RhD阴性孕妇进行产前抗RhD免疫球蛋白注射,以及对所有孕妇进行不规则红细胞抗原抗体筛查。由于此类抗体对检测新生儿溶血病的预测价值有限,所以该措施是否真正具有成本效益尚不确定。因为输血是免疫的最重要可能原因,且鉴于抗K抗体的临床严重性,建议仅向45岁以下的女性和女孩输注K阴性血。此外,需要有一个统一的方案来处理已接触过免疫的女性。

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