Changes and clinical significance of reticulocyte parameters in children with hemolytic disease of the newborn
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摘要: 目的 分析新生儿溶血病(HDN)患儿网织红细胞计数(RET)系列参数变化及临床意义。方法 收集55例HDN患儿的临床资料, 记录患儿入院时、治疗中、出院时静脉血RET系列参数。根据入院时网织红细胞计数百分比(RET%)基线值, 分为A组(RET%明显降低, 出院时RET%较入院时降低≥25%)、B组(RET%未明显降低, 出院时RET%较入院时降低 < 25%), 比较2组不同时间RET系列参数。结果 与入院时比较, 治疗中与出院时低荧光强度RET%(LFR%)显著提高, RET%、中荧光强度RET%(MFR%)、高荧光强度RET%(HFR%)、未成熟RET%(IRF%)均显著降低(P< 0.05)。与治疗中比较, 患儿出院时LFR%显著提高, RET%、MFR%、HFR%、IRF%均显著降低(P< 0.05)。A组治疗中与出院时LFR%显著提高, RET%、MFR%、HFR%、IRF%较入院时均明显降低(P< 0.05)；A组出院时LFR%高于治疗中水平, RET%、MFR%、HFR%、IRF%低于治疗中水平(P< 0.05)。B组治疗中和出院时RET%、LFR%、MFR%、HFR%、IRF%与入院时比较, 差异均无统计学意义(P>0.05)。A组RET%降低值(入院时—出院时)与LFR%、MFR%降低值均无显著相关性(r=-0.14、0.19, 均P>0.05), 而与HFR%、IRF%降低值均具有正相关关系(r=0.64、0.59, 均P< 0.05)。结论 RET%可视为评价HDN患儿治疗期间的敏感参数, 即RET%显著降低时, 提示疗效明显, 而LFR%、HFR%、IRF%可视为评估HDN治疗效果的重要辅助参数。
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关键词:
- 新生儿溶血病 /
- 网织红细胞 /
- 低荧光强度网织红细胞 /
- 中荧光强度网织红细胞 /
- 高荧光强度网织红细胞 /
- 未成熟网织红细胞
Abstract: Objective To analyze the changes and clinical significance of reticulocyte count(RET) in children with hemolytic disease of the newborn(HDN).Methods A retrospective study was conducted to collect the clinical data of 55 cases of HDN in our hospital. The RET series parameters of venous blood were recorded at the time of admission, treatment and discharge. According to the baseline value of RET% at admission, they were divided into group A(RET% decreased significantly, RET% at discharge was lower than that at admission by more than 25%) and group B(RET% didn't decrease significantly, RET% at discharge was lower than that at admission by less than 25%).Results Compared with admission, low-fluorescence intensity RET%(LFR%) increased significantly during treatment and discharge, RET%, medium-fluorescence intensity RET%(MFR%), high-fluorescence intensity RET%(HFR%), immature RET%(IRF%) decreased significantly(P< 0.05). Compared with the treatment, LFR% at discharge was significantly increased, RET%, MFR%, HFR% and IRF% were significantly decreased(P< 0.05). LFR% of group A was significantly increased during treatment and discharge, RET%, MFR%, HFR% and IRF% were significantly decreased compared with those at admission(P< 0.05); LFR% of group A at discharge was higher than that at treatment, RET%, MFR%, HFR% and IRF% were lower than those at treatment(P< 0.05). There was no significant difference in RET%, LFR%, MFR%, HFR% and IRF% between the two groups(P>0.05). There was no significant correlation between RET% and LFR%, MFR% in group A(r=-0.14, 0.19, bothP>0.05), but positive correlation between RET% and HFR%, IRF% in group A(r=0.64, 0.59, bothP< 0.05).Conclusion RET% can be regarded as a sensitive parameter to evaluate the therapeutic effect of hemolytic disease of the newborn. When RET% is significantly reduced, it may indicate that the curative effect is obvious. LFR%, HFR% and IRF% can be regarded as important auxiliary parameters to evaluate the therapeutic effect of HDN. -
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表 1 HDN患儿不同时间点RET系列参数比较
X±S 时间 RET% LFR% MFR% HFR% IRF% 入院时 7.74±1.04 63.58±13.05 21.95±3.06 17.06±2.47 38.97±6.58 治疗中 5.88±0.921) 72.25±9.661) 14.05±2.521) 11.04±1.581) 29.54±5.771) 出院时 3.25±0.831)2) 78.07±11.371)2) 10.05±1.691)2) 6.87±1.331)2) 23.05±4.711)2) 与入院时比较，1)P < 0.05；与治疗中比较，2)P < 0.05。 
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表 2 A组与B组入院时和出院时RET系列参数比较
X±S 组别 RET% LFR% MFR% HFR% IRF% A组 入院时 7.50±1.37 61.59±10.47 20.65±4.02 16.85±4.20 35.09±9.11 治疗中 4.98±0.931) 74.35±14.041) 16.85±3.061) 10.58±3.141) 27.86±6.531) 出院时 2.59±0.881)2) 77.06±9.891)2) 13.05±2.681)2) 7.07±2.511)2) 21.37±5.881)2) B组 入院时 5.82±1.59 62.24±15.59 18.74±4.04 19.57±5.05 38.75±10.55 治疗中 5.85±1.49 64.49±16.06 19.74±3.85 18.53±4.77 37.69±11.15 出院时 5.97±1.60 65.24±11.55 20.55±4.74 17.69±4.38 37.07±9.44 与本组入院时比较，1)P < 0.05；与本组治疗中比较，2)P < 0.05。
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