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[因抗-Rh(D)或免疫性抗A/B红细胞抗体导致的新生儿溶血病临床过程中细胞毒性抗-HL-A抗体的存在情况之间的相关性]

[Correlation between the presence of cytotoxic anti-HL-A antibodies in the clinical course of hemolytic disease of the newborn infant due to anti-Rh (D) or immune anti-A/B erythrocyte antibodies].

作者信息

Gligorović V N, Gligorović S, Susaković N, Lopicić L, Stolić I, Marković V, Matejić T

出版信息

Bilt Hematol Transfuz. 1976;4(3):23-31.

PMID:827283
Abstract

In a retrospective study the simultaneous influence of catotoxic HL-A antibodies on the clinical course of 60 cases of infants affected by Haemolytic disease on the Newborn due to anti Rh (D) or immune anti A/B antibodies, is shown. In all cases the treatment was by exange transfusion. In the group of infants in whose cord blood anti HL-A antibodies were found Exange transfusion had a weak efect so that it had to be repeated in 96 per cent of cases. In the group of infants in whose cord blood anti HL-S antibodies were not found, Exange transfusion was repeated only in one case, that is 2,7 per cent. In a group of Rh isommunised mothers whose children were affected by Haemolytic disease of the Newborn, antt HL-A antibodies were found in 61,7 per cent while 80,5 per cnet of the antibodies passed through the placente. In a group of ABO isoimmunised mothers cytotoxic HL-A antibodies were found in 42,3 per cent, while 45,4 per cent passed through the placente. A significant difference in the number of leucocytes, limphocytes, platelets, term of birth, level of bilirubin, amount of haemoglobin and Apgar Score was not found between the group of newborn who in their cord blood had, besides the already present isoimmunhaemagllutinines, cytotoxic HL-A antibodies and the group of infants with no cytotoxic anti HL-A antibodies, present. Cytotoxic HL-A antibodies in a way, react with the "unmasked" erythrocyte membrane, increasing haemolysis, so that the therapeutic effect of Exange transfusion was discriminated.

摘要

在一项回顾性研究中,显示了细胞毒性HL - A抗体对60例因抗Rh(D)或免疫性抗A/B抗体而患新生儿溶血病的婴儿临床病程的同时影响。所有病例均采用换血疗法。在脐血中发现抗HL - A抗体的婴儿组中,换血疗法效果不佳,以至于96%的病例需要重复换血。在脐血中未发现抗HL - S抗体的婴儿组中,仅1例(即2.7%)需要重复换血。在一组其孩子患新生儿溶血病的Rh免疫母亲中,61.7%发现了抗HL - A抗体,而80.5%的抗体通过了胎盘。在一组ABO血型免疫母亲中,42.3%发现了细胞毒性HL - A抗体,而45.4%的抗体通过了胎盘。在脐血中除了已有的同种免疫血凝素外还存在细胞毒性HL - A抗体的新生儿组与不存在细胞毒性抗HL - A抗体的婴儿组之间,未发现白细胞、淋巴细胞、血小板数量、出生孕周、胆红素水平、血红蛋白量和阿氏评分有显著差异。细胞毒性HL - A抗体以某种方式与“暴露的”红细胞膜发生反应,增加溶血,从而使换血疗法的治疗效果受到影响。

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