CAJ | 학술논문

目的：探讨红细胞免疫抗体引起的新生儿溶血病病例的母婴实验室检测结果、临床表现及治疗。方法回顾性分析4例红细胞免疫抗体引起的新生儿溶血病患儿及母亲产前相关实验室及临床资料。结果4例患儿的母亲在孕期分别检测出IgG性质的红细胞抗E、抗D、抗Jkb及自身抗体；效价分别为16、2048、1及16。患儿均足月分娩，但生后6h~3d出现不同程度的皮肤黄染，伴或不伴贫血。患儿红细胞放散试验发现存在与母体相同的抗体，效价分别为4、512、0及2。患儿均予光照治疗，2例重症患儿予换血及输血治疗，均预后良好。结论孕妇产前免疫血液学检查有助于及早发现红细胞不规则抗体以评估胎儿及新生儿溶血病风险。
목적：탐토홍세포면역항체인기적신생인용혈병병례적모영실험실검측결과、림상표현급치료。방법회고성분석4례홍세포면역항체인기적신생인용혈병환인급모친산전상관실험실급림상자료。결과4례환인적모친재잉기분별검측출IgG성질적홍세포항E、항D、항Jkb급자신항체；효개분별위16、2048、1급16。환인균족월분면，단생후6h~3d출현불동정도적피부황염，반혹불반빈혈。환인홍세포방산시험발현존재여모체상동적항체，효개분별위4、512、0급2。환인균여광조치료，2례중증환인여환혈급수혈치료，균예후량호。결론잉부산전면역혈액학검사유조우급조발현홍세포불규칙항체이평고태인급신생인용혈병풍험。
Objective To investigate the laboratory ifndings, clinical manifestations and treatment in hemolytic disease caused by red cell immune antibodies in neonates. Methods The laboratory and clinical data from 4 cases of hemolytic disease of neonates caused by red cell immune antibodies were retrospectively analyzed. Results IgG antibody were detected in all mothers of 4 cases during pregnancy and they were anti-E, anti-D, anti-Jkb and the autoantibody with the titer being 16, 2048, 1 and 16 respectively. The four neonates were all full-term. The jaundice appeared 6 h to 3 d after birth with varying degrees of skin stained yellow, with or without anemia. Serology and elution test found the existence of antibody same as the one on their maternal red cells and the titer was 4, 512, 0, and 2, respectively. All neonates were treated by phototherapy. Two servere cases were also treated by whole blood exchange and red blood cells transfusion. The prognosis were good in all neonates. Conclusions Prenatal immune hematological tests facilitated early detection of irregular erythrocyte antibodies and thus assessment of the risk of hemolytic dis-ease of the fetus and neonates.