Wu K H, Chu S L, Chang J G, Shih M C, Peng C T
China Medical College Hospital, Taichung, Taiwan.
Transfus Med. 2003 Oct;13(5):311-4. doi: 10.1046/j.1365-3148.2003.00458.x.
From 1991 to 2000, amongst 23,886 full-term healthy Chinese babies delivered at our hospital, 2615 babies developed neonatal hyperbilirubinaemia. After excluding other causes of hyperbilirubinaemia and identifying the irregular antibodies, 15 cases of haemolytic disease of the newborn (HDN) due to maternal irregular antibodies were diagnosed; three cases were born in our hospital and 12 cases were referred. Amongst these 15 babies, six cases had HDN due to anti-E, three cases due to anti-E + c, three cases due to anti-D, one case due to anti-c and two cases due to 'Mi' antibodies reacting with MiIII phenotype cells (anti-Hil and anti-Mur). Although there were four cases of hydrops fetalis, only one of the patients expired. The prevalence of HDN caused by maternal irregular antibodies has been estimated to be 0.01%. Therefore, routine prenatal screening for irregular antibodies was not rational in the Chinese population in Taiwan. Anti-E and anti-E + c were the important irregular antibodies resulting in HDN. Although few cases of HDN due to anti-'Mi' have been reported, Anti-'Mi' is significant in regions with a high prevalence of the MiIII phenotype.
1991年至2000年期间，在我院出生的23,886名足月健康中国婴儿中，有2615名婴儿发生了新生儿高胆红素血症。在排除高胆红素血症的其他病因并鉴定不规则抗体后，诊断出15例由母体不规则抗体引起的新生儿溶血病（HDN）；其中3例在我院出生，12例为转诊病例。在这15名婴儿中，6例因抗 - E导致HDN，3例因抗 - E + c，3例因抗 - D，1例因抗 - c，2例因与MiIII表型细胞反应的“Mi”抗体（抗 - Hil和抗 - Mur）。尽管有4例胎儿水肿，但仅1例患者死亡。据估计，由母体不规则抗体引起的HDN患病率为0.01%。因此，在台湾的中国人群中，常规产前筛查不规则抗体并不合理。抗 - E和抗 - E + c是导致HDN的重要不规则抗体。虽然因抗“Mi”导致HDN的病例报道较少，但在MiIII表型高流行地区，抗“Mi”具有重要意义。
