ABO 不合与脐血单位红细胞指数的关系。

Association of ABO incompatibility with red blood cell indices of cord blood unit.

机构信息

Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan.

出版信息

Pediatr Neonatol. 2012 Apr;53(2):138-43. doi: 10.1016/j.pedneo.2012.01.012. Epub 2012 Mar 2.

DOI:10.1016/j.pedneo.2012.01.012

PMID:22503262

Abstract

BACKGROUND

Maternal-fetal ABO incompatibility is one of the causes of neonatal hyperbilirubinemia. We postulate that hemoglobin (Hb), hematocrit (Hct), and red blood cell (RBC) values for cord blood units (CBUs) are lower and erythroblast values higher for maternal-fetal ABO incompatible dyads than for compatible dyads.

OBJECTIVE

We investigated the relationship between Hb, Hct, RBC, and erythroblast CBU values and maternal-fetal ABO blood type compatibility.

METHODS

Mothers having blood group O who gave birth to infants with blood group A, B, or AB were classified as Group I. According to baby's blood group, the members of Group I were further divided into AO (baby group A, mother group O), BO (baby group B, mother group O), and ABO (baby group AB, mother group O) subgroups. Mothers having blood group A who gave birth to infants with blood group B or AB and mothers having blood group B who gave birth to infants with blood group A or AB were classified as Group II. All other maternal-fetal blood type pairs were considered ABO compatible and were classified as Group III. We compared mean Hb, Hct, RBC, and erythroblast values for the infants' CBUs among these three groups including the subgroups of Group I.

RESULTS

Group I had lower mean Hb, Hct, and RBC values than Group II and Group III (both p < 0.001). Although the mean Hb, Hct, and RBC values for Group II were lower than for Group III, the difference was not statistically significant. Mean Hb and RBC for the AO group were higher and nucleated RBC (nRBC) ratios were lower than for the BO group; however, these differences were also not statistically significant. Interestingly, the mean Hct value of the BO group was significantly lower than that of the AO group (p = 0.04).

CONCLUSION

Group A or B neonates with a group O mother have lower mean Hb, Hct, and RBC values for CBUs than other neonates. The role of RBC indices in predicting neonatal hemolytic hyperbilirubinemia remains unclear and further studies are needed to identify the possible clinical association.

摘要

背景

母婴 ABO 血型不合是新生儿高胆红素血症的原因之一。我们推测，与母婴 ABO 血型相容的双胎相比，母婴 ABO 血型不合的双胎的脐血单位（CBU）中的血红蛋白（Hb）、血细胞比容（Hct）和红细胞（RBC）值较低，而有核红细胞（nRBC）值较高。

目的

我们研究了 Hb、Hct、RBC 和 nRBC 的 CBU 值与母婴 ABO 血型相容性之间的关系。

方法

将母亲血型为 O 型、婴儿血型为 A、B 或 AB 的母亲分为 I 组。根据婴儿的血型，I 组的成员进一步分为 AO（婴儿血型 A，母亲血型 O）、BO（婴儿血型 B，母亲血型 O）和 ABO（婴儿血型 AB，母亲血型 O）亚组。母亲血型为 A 型、婴儿血型为 B 或 AB 型，母亲血型为 B 型、婴儿血型为 A 或 AB 型的母亲被分为 II 组。所有其他母婴血型对均被认为是 ABO 相容的，并被分为 III 组。我们比较了这三组包括 I 组的亚组中婴儿 CBU 的平均 Hb、Hct、RBC 和 nRBC 值。

结果

I 组的平均 Hb、Hct 和 RBC 值低于 II 组和 III 组（均 p < 0.001）。尽管 II 组的平均 Hb、Hct 和 RBC 值低于 III 组，但差异无统计学意义。AO 组的平均 Hb 和 RBC 值较高，nRBC 比值较低，但这些差异也无统计学意义。有趣的是，BO 组的平均 Hct 值明显低于 AO 组（p = 0.04）。