Correlation analysis between age of ABO newborn hemolysis patients and bilirubin level
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摘要: 目的 通过对南京医科大学附属儿童医院新生儿溶血病(HDN)发生情况进行回顾调查分析，探讨ABO-HDN患儿就诊日龄与血清总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)水平的关系。方法 选取2021年1月至2021年12月收治的235例确诊为ABO-HDN且母亲为O型的患儿作为研究对象，检测其溶血3项试验、血清TBIL、DBIL、IBIL水平，同时回顾分析其就诊日龄等临床资料。结果 对54.89%(129/235)的顺产患儿与45.11%(106/235)的剖腹产患儿以及18.30%(43/235)胎龄28~36周患儿与81.70%(192/235)胎龄≥37周患儿在TBIL、IBIL水平上比较，差异有统计学意义(P < 0.05)；12.77%(30/235)的患儿就诊日龄≤1 d、17.45%(41/235)的患儿就诊日龄2 d、69.79%(164/235)就诊日龄≥3 d对TBIL、DBIL、IBIL水平进行比较，差异有统计学意义(P < 0.05)。结论 对疑似有ABO-HDN的患儿及时进行溶血3项和TBIL、DBI、IBIL检测，对ABO-HDN的预防及治疗有重要意义。Abstract: Objective To explore the relationship between the age of seeing a doctor and total bilirubin(TBIL), direct bilirubin(DBIL) and indirect Bilirubin(IBIL) based on the retrospective investigation and analysis of the occurrence of neonatal hemolytic disease in our hospital.Methods From January 2021 to December 2021, 235 children diagnosed as ABO newborns hemolytic disease and mother for type O treated in Nanjing Medical University affiliated Children's Hospital were selected as the research object. Three detection of the neonatal hemolysis and detection of serum total bilirubin, direct bilirubin and indirect bilirubin level were carried out, and clinical data at the same time including the clinic day age was retrospective analyzed.Results The TBIL and IBIL levels were statistically significant in 54.89%(129/235) of children with vaginal delivery, 45.11%(106/235) of children with caesarean section, 18.30%(43/235) of children with gestational age of 28-36 weeks and 81.70%(192/235) of children with gestational age ≥37 weeks(P < 0.05); 12.77%(30/235) of the children were less than 1 day old, 17.45%(41/235) were 2 days old, and 69.79%(164/235) were ≥3 days old. The comparison of TBIL, DBIL and IBIL levels was statistically significant(P < 0.05).Conclusion The timely detection of three tests of the neonatal hemolysis and TBIL, DBI and IBIL may be of great significance for the prevention and treatment of ABO-HDN in children suspected to have ABO hemolytic disease.
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Key words:
- emolytic disease of newborn /
- total bilirubin /
- direct bilirubin /
- indirect bilirubin /
- clinic day age
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表 1 235例ABO-HDN患儿基本情况与TBIL、DBIL、IBIL水平相关性分析
μmol/L，X±S 组别 例数/例(%) TBIL DBIL IBIL t TBIL DBIL IBIL 性别 0.495 0.756 0.626 男 124(52.77) 234.594±86.638 19.617±5.997 214.931±84.421 女 111(47.23) 228.226±108.877 21.019±18.684 207.206±106.390 血型 1.452 1.570 1.275 A 133(56.60) 223.487±104.489 19.068±7.364 204.419±99.315 B 102(43.40) 242.091±87.223 21.859±18.703 220.232±87.184 多胎 1.675 1.043 1.691 是 13(5.53) 235.991±90.352 20.502±13.694 215.488±87.785 否 222(94.47) 155.934±170.932 16.472±10.398 139.462±160.745 孕产/胎 1 109(46.38) 230.057±92.095 21.333±18.507 208.723±90.928 0.003 1.075 0.157 2 113(48.09) 230.014±97.572 19.345±6.473 210.668±93.168 0.920 0.110 0.959 ≥3 13(5.53) 257.638±140.804 19.565±9.621 238.073±131.945 0.959 0.338 1.044 分娩方式 2.223 1.856 2.048 顺 129(54.89) 244.284±88.359 21.652±17.298 222.632±86.932 剖 106(45.11) 216.079±106.186 18.609±6.251 197.470±101.48 胎龄/周 4.042 1.667 5.627 28~36 43(18.30) 160.374±136.362 17.099±8.492 143.275±129.567 ≥37 192(81.70) 247.505±78.662 20.894±14.627 226.523±77.108 就诊日龄/d 1 30(12.77) 138.753±79.096 13.930±84.484 124.814±75.965 2.962 2.305 2.943 2 41(17.45) 202.064±95.462 16.889±5.864 185.175±91.588 3.414 2.941 3.143 ≥3 164(69.79) 255.914±89.039 22.287±15.397 233.627±87.471 6.735 2.202 6.384 
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