發(fā)布時間：2018-03-02 00:30

  本文關(guān)鍵詞： 新生兒 ABO溶血 胎齡 影響　出處：《昆明醫(yī)科大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：回顧性分析196例不同胎齡別體重新生兒ABO溶血病(ABO-HDN)病例。對入院期間血生化、凝血功能及血糖的變化進行分析,并就新生兒ABO溶血病對器官功能的影響進行評價。方法：選取2013年2月至2016年4月期間昆明醫(yī)科大學(xué)第二附屬醫(yī)院兒科新生兒病區(qū)收治的確診新生兒ABO溶血病196例,分為小于胎齡組(SGA組,n=29),適于胎齡組(AGA組,n=132),大于胎齡組(LGA組,n=35)；并隨機選取同期住院無黃疸的處于疾病恢復(fù)期足月新生兒為對照組(n=75),所有觀察組的新生兒均在入院后立即檢測血生化、凝血功能及血糖,并對這些指標的變化進行統(tǒng)計學(xué)分析。結(jié)果：1.肝功能(1)SGA組、AGA組、LGA組和對照組ALT值分別為(19.54±3.88 U/L)、(20.29±3.70 U/L)、(16.54±3.50 U/L)、(13.45±1.48 U/L),SGA組和AGA組ALT測定值均高于對照組,差異具有統(tǒng)計學(xué)意義(P0.05),其余兩兩組比較無差異(P0.05)。(2)SGA組、AGA組、LGA組和對照組AST測定值分別為(63.24±10.68 U/L)、(59.02±3.53 U/L)、(53.79±±8.12 U/L)、(41.36±3.88 U/L),三個研究組AST值較對照組升高,差異有統(tǒng)計學(xué)意義(P0.05),其余兩兩組比較無統(tǒng)計學(xué)意義(P0.05)。2.腎功能SGA組、AGA組、LGA組和對照組血清BUN和CREA測定值分別為(3.20±0.85mmol/l；56.20±7.76 u mol/l)、(3.43±0.33 mmol/l；55.89±6.07umol/l)、(3.04±0.65 mmol/1;50.75±7.69μmol/1)、(2.94±0.32 mmol/l；51.58±5.33μmol/1),進行兩兩組比較,差異無統(tǒng)計學(xué)意義(P0.05)。3.心肌酶SGA組、AGA組、LGA組和對照組CK-MB測定值分別為(53.48±11.59 U/L)、(42.83±3.96 U/L)、(39.08±6.67 U/L)、(28.69±4.38 U/L),三個觀察組CK-MB值均高于對照組,差異具有統(tǒng)計學(xué)意義(P0.05),其余兩兩組比較無統(tǒng)計學(xué)意義(P0.05)。4.凝血功能(1)SGA組、AGA組、LGA組和對照組PT值分別為(18.86±2.85s)、(16.45±1.73s)、(17.14±2.65s)、(15.60±1.49s),SGA組和LGA組PT測定值均高于對照組,差異具有統(tǒng)計學(xué)意義(P0.05),其余兩兩組比較無差異(P0.05)。(2)SGA組、AGA組、LGA組和對照組APTT測定值分別為(54.70±7.62s)、(42.35±3.18s)、(42.13±4.73s)、(38.56±2.02s),三個觀察組APTT值均較對照組升高,差異具有統(tǒng)計學(xué)意義(P0.05)；SGA組APTT值高于AGA組、LGA組,差異有統(tǒng)計學(xué)意義(P0.05)；其余兩兩組比較無差異(P0.05)。(3)SGA組、AGA組、LGA組和對照組FIB值分別為(2.80±0.35 g/1)、(2.85±0.21 g/1)、(3.01±0.39 g/1)、(2.87±0.20 g/1),進行兩兩組比較,差異無統(tǒng)計學(xué)意義(P0.05)。(4)SGA組、AGA組、LGA組和對照組TT測定值分別為(18.07±3.80s)、(16.73±2.69s)、(16.47±1.26s)、(15.89±2.57s),SGA組TT測定值較對照組增高,差異有統(tǒng)計學(xué)意義(P0.05),其余兩兩組比較無差異(P0.05)。5.血糖SGA組、AGA組、LGA組發(fā)生低血糖率分別為3.44%、3.78%、0.00%,所有研究組低血糖發(fā)生率3.06%。這三個觀察組發(fā)生低血糖情況比較無統(tǒng)計學(xué)意義(P0.05)。結(jié)論：1.新生兒ABO溶血病可能引起肝功、腎功、心肌酶、凝血功能和糖代謝的異常。2.不同胎齡別體重新生兒ABO溶血病對器官功能的影響之間無明顯相關(guān)性。
[Abstract]:Objective: to retrospectively analyze 196 cases of ABO hemolytic disease of newborns of different gestational age, and analyze the changes of blood biochemistry, coagulation function and blood glucose during admission. The effects of neonatal ABO hemolytic disease on organ function were evaluated. Methods: from February 2013 to April 2016, 196 cases of neonatal ABO hemolytic disease were selected and treated in pediatric neonatal ward of the second affiliated Hospital of Kunming Medical University. It was divided into small gestational age group and SGA group, suitable for gestational age group and AGA group, and larger than LGA group for gestational age group, and randomly selected term neonates without jaundice in the same period as control group. All the newborns in observation group were all admitted to hospital. Immediately test blood biochemistry, The changes of blood coagulation function and blood glucose were analyzed statistically. Results: the ALT values of AGA group and control group were 19.54 鹵3.88 U / L, 20.29 鹵3.70 U / L, 16.54 鹵3.50 UL / L, 13.45 鹵1.48 UL / L SGA and 1.48 UL / L AGA, respectively, which were significantly higher than those in control group. The difference was statistically significant (P 0.05). The AST of the other two groups were 63.24 鹵10.68 U / L and 59.02 鹵3.53 U / L / L respectively. The AST values of the three study groups were 41.36 鹵3.88 U / L / L ~ (-1) and 41.36 鹵3.88 U / L / L ~ (-1), respectively. The serum BUN and CREA in the renal function SGA group and the control group were 3.20 鹵0.85 mmol / L 56.20 鹵7.76 mmol / L respectively (3.43 鹵0.33 mmol / L = 55.89 鹵6.07 mmol / L) 3.04 鹵0.65 mmol / 1 鹵7.69 渭 mol / L / L respectively. There was no significant difference in CK-MB between SGA group and control group (P < 0.05). The CK-MB values were 53.48 鹵11.59 U / L, 42.83 鹵3.96 U / L, 39.08 鹵6.67 U / L and 28.69 鹵4.38 U / L, respectively. The CK-MB values of the three observation groups were higher than those of the control group. The difference was statistically significant (P 0.05), but there was no significant difference between the other two groups. The PT values of LGA group and control group were higher than those of control group. The PT values in SGA group and LGA group were higher than those in control group. The PT values in SGA group and LGA group were higher than those in control group. The PT values in SGA group and LGA group were higher than those in control group. The PT values in SGA group and LGA group were significantly higher than those in control group (P < 0.05), and the PT values in SGA group and LGA group were significantly higher than those in control group. There was no significant difference between the other two groups (P 0.05, P 0.05, P 0.05, P 0.05), and the APTT values of the control group and the control group were 42.35 鹵3.18 s and 42.13 鹵4.73 sl, respectively. The APTT values of the three observation groups were higher than those of the control group, and the APTT values of the three observation groups were significantly higher than those of the AGA group. There was no significant difference between the other two groups in the FIB values of the AGA group and the control group were 2.80 鹵0.35 g / L and 2.85 鹵0.21 g / 1 / 1 respectively, and the FIB values of the two groups were 3.01 鹵0.39 g / 1 2.87 鹵0.20 g / 1, respectively. There was no significant difference in TT between LGA group and control group in AGA group and control group. The TT of SGA group was higher than that of control group. The TT of SGA group was higher than that of control group (P < 0.05). The TT of SGA group was higher than that of control group (P < 0.05), the TT of LGA group and control group were 16.73 鹵2.69 sl, respectively, and the TT of SGA group was higher than that of control group. The hypoglycemia rate in SGA group was 3.44 and 3.780.000.The incidence of hypoglycemia in all study groups was 3.060.There was no significant difference between the other two groups. There was no significant difference in hypoglycemia among the three observation groups. Conclusion: 1. Neonatal ABO hemolytic disease may cause liver function, Abnormal renal function, myocardial enzymes, coagulation function and glucose metabolism. There was no significant correlation between ABO hemolytic disease and organ function in neonates with different gestational weight.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R722.18

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