Liu Xin, LE Fang, Wang Lian-Hui, Shu Jin, Xu Xiu-Yun
Department of Blood Transfusion， Jiangxi Provincial Children's Hospital， The Affiliated Children's Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China.
Department of Blood Transfusion， Jiangxi Provincial Children's Hospital， The Affiliated Children's Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China,E-mail：
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Feb;31(1):215-220. doi: 10.19746/j.cnki.issn.1009-2137.2023.01.034.
To analyze the characteristics of antibody-specific distribution, laboratory detection results of hemolytic disease of the fetus and neonatal(HDFN) caused by irregular blood group antibodies other than ABO, and its correlation with the clinical situation.
The non-ABO-HDFN cases in our hospital from October 2012 to December 2021 were selected as the research objects, and the cases diagnosed with ABO-HDFN in the same period were randomly selected as the control group, and the data of antibody specific distribution, total bilirubin, direct antibodies, maternal history, age of the children, the presence or absence of combined ABO-HDFN, and whether to exchange/transfuse blood were retrospectively analyzed. The characteristics of non-ABO-HDFN in Jiangxi province were analyzed.
The detection rate of non-ABO-HDFN in Jiangxi province increased. Among 187 non ABO-HDFN cases, the highest percentage of Rh-HDFN was detected (94.6%). Compared with the control group of ABO-HDFN, the non-ABO-HDFN had higher mean integral value of direct antibody, higher peak total bilirubin, and longer duration. Anti-M-HDFN may have severe disease but the direct antibody weak positive/negative, it was easy missed in clinical and delayed the treatment. There is no correlation between the specificity of irregular antibodies, the sex of the child, the mother's previous childbirth history, the presence or absence of combined ABO-HDFN and the need for blood exchange/transfusion(>0.05).
The irregular antibodies of causing non ABO-HDFN in Jiangxi area are mainly Rh blood group system, followed by MNS blood group system. Understanding the characteristics of HDFN disease, serological features and the correlation with clinical indexes will help to detect and treat non ABO-HDFN in time and reduce the risk of complications.
分析由ABO以外不规则血型抗体引起的胎儿及新生儿溶血病（HDFN）的抗体特异性分布特点、实验室检测结果及其与临床情况的相关性。
选取2012年10月至2021年12月我院收治的非ABO-HDFN病例作为研究对象，同期随机选取诊断为ABO-HDFN的病例作为对照组，回顾性分析抗体特异性分布、总胆红素、直接抗体、母亲病史、患儿年龄、是否合并ABO-HDFN以及是否进行换血/输血等数据。分析江西省非ABO-HDFN的特点。
江西省非ABO-HDFN的检出率上升。187例非ABO-HDFN病例中，Rh-HDFN检出比例最高（94.6%）。与ABO-HDFN对照组相比，非ABO-HDFN的直接抗体平均积分值更高、总胆红素峰值更高、病程更长。抗-M-HDFN病情可能较重但直接抗体弱阳性/阴性，临床易漏诊并延误治疗。不规则抗体特异性、患儿性别、母亲既往生育史、是否合并ABO-HDFN以及是否需要换血/输血之间无相关性（>0.05）。
江西地区引起非ABO-HDFN的不规则抗体主要为Rh血型系统，其次为MNS血型系统。了解HDFN疾病特点、血清学特征及其与临床指标的相关性，有助于及时诊治非ABO-HDFN并降低并发症风险。
