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[恒河猴红细胞增多症,监测与治疗]

[Rhesus erythroblastosis, monitoring and treatment].

作者信息

Siebers J W, Rasenack R, Hillemanns H G

出版信息

Zentralbl Gynakol. 1985;107(20):1226-42.

PMID:3934880
Abstract

From 1975-1984 92 pregnancies with suspicion of a morbus hemolyticus fetalis were monitored at the University Hospital of Freiburg, Department of Obstetrics and Gynecology. Most of the patients had antibodies against the rhesusfactor D. Amniocentesis was carried out regularly; the bilirubin level and protein content of the amniotic fluid were measured using chemical methods and the bilirubin/protein ratio was determined. The results obtained correlated well with the values of spectrophotometrically measured bilirubin, which reliably indicated the severity of the hemolytic disease. A serious erythroblastosis was observed in 17 cases. Four children died before any treatment was initiated. In 13 children 37 intrauterine transfusions (IUT) were performed. The survival rate of the children with IUT's was 69%, in nonhydropic children it was 82%. The mortality risk of the IUT was low. Children with IUT's often showed complications in the perinatal period, which were due to the premature birth and the erythroblastosis.

摘要

1975年至1984年期间,弗赖堡大学医院妇产科对92例疑似胎儿溶血病的妊娠进行了监测。大多数患者体内存在抗恒河猴因子D的抗体。定期进行羊膜穿刺术;采用化学方法测量羊水的胆红素水平和蛋白质含量,并确定胆红素/蛋白质比值。所获得的结果与分光光度法测量的胆红素值相关性良好,该值可靠地表明了溶血病的严重程度。观察到17例严重的成红细胞增多症。4名儿童在开始任何治疗前死亡。13名儿童接受了37次宫内输血(IUT)。接受IUT治疗的儿童存活率为69%,非水肿儿童为82%。IUT的死亡风险较低。接受IUT治疗的儿童在围产期常出现并发症,这是由于早产和成红细胞增多症所致。

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