新生兒ABO血型不合症之研究

兩年前，自從檢驗室能提供anti-A及anti-B的檢驗後，我們能從事新生兒ABO不合症的研究，我們先選擇18位沒有高膽紅素症的A型或B型的新生兒，測其O型母親的抗A抗B力價，發現18位中，有15位均低於100以下，只有2位是400，一位是800。反過來，我們再選擇34位有高膽紅素症的A型或B型的新生兒，測其母親的抗體力價，發現34位中，有20位高於400，有4位是256，有3位是200，其餘7位是128以下，綜合以上所述，我們可以看出母親的抗體力價與新生兒的高膽紅素有密切的關係，但不是百分之百的平行關係。本文亦敘述當ABO不合時，新生兒接受輸血或換血時應注意所選擇的血液，以免發生不良的後果。

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並列摘要

A study of ABO incompatibility and hemolytic disease was carried out in the Pediatric Department of Mackay Memorial Hospital from 1982 to 1984. Coombs' test, eluted anti-A or anti-B, maternal antibodies, as well as bilirubin were determined in ABO-incompatible babies. The maternal antibodies were rather low in 18 babies without significant jaundice, but in 2 babies, maternal antibodies were 400× and in 1,800×. Of 34 patients with hyperbilirubinemia, maternal antibodies were higher than 400× in 20 patients, 256× in 4,200× in 3 and less than 128× in 7. Although there appeared to be no linear relationship between the antibody titer and the degree of jaundice, the maternal antibody titer definitely serves as a useful diagnostic tool in ABO incompatibility and hemolytic disease. In neonates with titer of 1,000× or more, significant hemolytic signs and symptoms were noted; i. e., early onset of jaundice, positive Coombs' test and eluted antibody, mild anemia and reticulocytosis. With titers of 128× or less, the infants had no clinical manifestations. Between these ranges, the symptoms depended on the antigenicity of the fetal RBC and the biological activity of the maternal antibody. Lastly, emphasis should be stressed of the importance of careful selection of donor blood used for transfusion or exchange transfusion for ABO incompatible newborns to avoid severe transfusion reaction. Transfusion is a major undertaking and entails both risk and complications.

並列關鍵字

ABO incompatibility ； ABO hemolytic disease ； hyperbilirubinemia ； maternal anti -A and -B ； exchange transfusion ； neonatal transfusion

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新生兒ABO血型不合症之研究

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