Department of Pediatrics and Neonatology, Institute of Fetal-Preterm Labor Medicine, The First Affiliated Hospital of Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China.
The First People's Hospital of Foshan, Foshan, 528010, China.
BMC Pregnancy Childbirth. 2023 Apr 22;23(1):276. doi: 10.1186/s12884-023-05558-w.
Not all infants with persistent pulmonary hypertension of the newborn (PPHN) respond to inhaled nitric oxide (iNO) therapy, as it is known to improve oxygenation in only 50% to 60% of cases. In this study, we investigated whether ABO blood groups were a relevant factor affecting the improvement of oxygenation by nitric oxide (NO) therapy in infants with PPHN.
This study was a retrospective, multicenter, and cohort-controlled trial that involved 37 medical units. Infants with PPHN who met the inclusion criteria and were treated with NO (a vasodilator) alone from July 1, 2015, to June 30, 2020, were selected and assigned into three groups: blood type A, blood type B, and blood type O (there were only 7 cases of blood type AB, with a small number of cases, and therefore, blood type AB was excluded for further analysis). The response to iNO therapy was defined as an increase in the ratio of the partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) > 20% from the basal value after treatment. Oxygenation was assessed mainly based on the two values, oxygenation index (OI) and PaO2/FiO2. The correlation of ABO blood groups with responses to iNO therapy and their influence on the efficacy of iNO therapy was analyzed based on the collected data.
The highest proportion of infants with PPHN who eventually responded to iNO therapy was infants with blood type O. Infants with blood type O more readily responded to iNO therapy than infants with blood type B. Oxygenation after iNO treatment group was optimal in the blood type O group and was the worst in the blood type A group among the three groups. Infants with blood type O showed better efficacy than those with blood types A and B.
ABO blood groups are correlated with responses to iNO therapy in infants with PPHN, and different blood groups also affect the efficacy of NO therapy in infants with PPHN. Specifically, infants with blood type O have a better response and experience the best efficacy to iNO therapy.
并非所有新生儿持续性肺动脉高压（PPHN）患者对吸入一氧化氮（iNO）治疗有反应，因为已知该治疗仅能使 50%至 60%的病例的氧合情况得到改善。在本研究中，我们研究了 ABO 血型是否是影响一氧化氮（NO）治疗对 PPHN 婴儿氧合作用的相关因素。
本研究为回顾性、多中心、队列对照试验，共涉及 37 个医疗单位。选择并分配符合纳入标准且于 2015 年 7 月 1 日至 2020 年 6 月 30 日期间仅接受一氧化氮（血管扩张剂）治疗的 PPHN 婴儿进入三组：A 型血、B 型血和 O 型血（AB 型血仅有 7 例，病例数较少，因此，AB 型血排除进一步分析）。iNO 治疗的反应定义为治疗后动脉氧分压（PaO2）/吸入氧分数（FiO2）比值比基础值增加>20%。氧合主要基于两个值（氧合指数（OI）和 PaO2/FiO2）进行评估。根据收集的数据，分析 ABO 血型与 iNO 治疗反应的相关性及其对 iNO 治疗效果的影响。
最终对 iNO 治疗有反应的 PPHN 婴儿中，O 型血婴儿的比例最高。O 型血婴儿比 B 型血婴儿更易对 iNO 治疗有反应。在 iNO 治疗组中，O 型血婴儿的氧合最佳，而 A 型血婴儿的氧合最差。O 型血婴儿的疗效优于 A 型和 B 型婴儿。
ABO 血型与 PPHN 婴儿对 iNO 治疗的反应相关，不同血型也影响 PPHN 婴儿接受 NO 治疗的效果。具体而言，O 型血婴儿对 iNO 治疗的反应更好，疗效最佳。
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