HDN

摘要： 目的:探讨二孩孕妇Rh血型系统5个抗原的表型分布和Rh血型不规则抗体特异性情况,分析二孩孕妇Rh血型抗体与新生儿溶血病(hemolytic disease of the newborn,HDN)的关系,为Rh新生儿溶血病(Rh-HDN)的诊治提供实验室依据。方法:收集二孩孕妇500例作为研究组,初次妊娠孕妇500例作为对照组(均为2020年1月~2021年1月在我院一体化产科门诊进行产检的孕妇),检测两组标本的Rh血型抗原(D、C、c、E、e五个抗原)、不规则抗体检测、抗体特异性鉴定和效价测定,跟踪新生儿溶血病的发生情况。结果:研究组500例二孩孕妇中共有12种Rh血型表型,分别为:CCDee(152例,30.4%),CcDEe(136例,27.2%),CcDee(84例,16.8%),ccDEE(30例,6%),ccDee(31例,6.2%),CCDEe(14例,2.8%),ccDEe(9例,1.8%),ccdee(18例,3.6%),CCDEE(2例,0.4%),CcdEe(12例,2.4%),Ccdee(6例,1.2%),CCdee(6例,1.2%),其中RhD阴性的二孩孕妇共42例,比例为8.4%。对照组500例初次妊娠孕妇,共有11种Rh血型表型,分别为:CCDee(144例,28.8%),CcDEe(138例,27.6%),CcDee(90例,18%),ccDEE(42例,8.4%),ccDee(28例,5.6%),CCDEe(10例,2%),ccDEe(8例,1.6%),ccdee(19例,3.8%),CCDEE(1例,0.2%),CcdEe(11例,2.2%),Ccdee(9例,1.8%),其中RhD阴性的初次妊娠孕妇共39例,比例为7.8%。研究组二孩孕妇不规则抗体检测阳性率为4.0%(20/500),Rh血型抗体的特异性分别为:抗-E 1.8%(9/500),抗-D 1.4%(7/500),抗-C 0.4%(2/500),抗-Ec 0.4%(2/500);对照组初次妊娠孕妇不规则抗体检测阳性率为0。二孩孕妇与初次妊娠孕妇不规则抗体检测阳性率的差异有统计学意义(P<0.05)。二孩孕妇中共有10例分娩的新生儿发生Rh新生儿溶血病,占2%(10/500),且孕期Rh抗体效价均大于32;初次妊娠孕妇分娩的的新生儿未发生Rh新生儿溶血病,差异有统计学意义(P<0.05)。结论:妊娠刺激可增加孕妇产生不规则抗体的概率,Rh血型不规则抗体容易引起Rh-HDN,应重视孕妇产检期间Rh血型5个抗原和不规则抗体的常规检测,有助于早期发现Rh血型不规则抗体及评估胎儿或者新生儿发生Rh-HDN的风险。

摘要： Objective:To investigate the phenotype distribution of five antigens of Rh blood group system and the specificity of Rh blood group irregular antibodies in pregnant women with second child.To analyze the relationship between Rh blood group antibody and hemolytic disease of the newborn(HDN)in second-child pregnant women,and to provide laboratory basis for the diagnosis and treatment of hemolytic disease of the newborn(Rh-HDN).Methods:500 pregnant women with second child were collected as the study group and 500 pregnant women with first pregnancy as the control group(all pregnant women underwent obstetric examination in the integrated obsteric clinic of our hospital from January 2020 to January 2021).To detectethe Rh blood group antigens(D,C,c,E,e)of the two groups of samples,screene the irregular antibodies,identify the specificity of irregular antibodies,determine the titer and record the hemolytic disease of the newborn of pregnant women with positive Rh blood group antibodies.Results:There were 11 Rh phenotypes in the pregnant women with second child in the study group:CCDee(152cases,30.4%),CcDEe(136cases,27.2%)CcDee(84cases,16.8%),ccDEE(30cases,6%),ccDee(31cases,6.2%),CCDEe(14cases,2.8%),ccDEe(9cases,1.8%),cc dee(18cases,3.6%),CCDEE(2cases,0.4%),CcdEe(12cases,2.4%),Ccdee(6cases,1.2%),CCd ee(6cases,1.2%).A total of 42 cases(8.4%)in the pregnant women with second child were negative for RhD.There were 10 Rh phenotypes in the pregnant women with first pregnancy in the control group:CCDee(144cases,28.8%),CcDEe(138cases,27.6%),CcDee(90cases,18%),ccDEE(42cases,8.4%),ccDee(28cases,5.6%),CCDEe(10cases,2%),ccDEe(8cases,1.6%),cc dee(19cases,3.8%),CCDEE(1cases,0.2%),CcdEe(11cases,2.2%),Ccdee(9cases,1.8%).A total of 39 cases(7.8%)in the pregnant women with first pregnancy were negative for RhD.In the pregnant women with second child in the study group,the positive rate of irregular antibody screening was 4.0%(20/500),and the specificity of Rh blood group antibodies was found as follows:anti-E 1.8%(9/500),anti-D 1.4%(7/500),anti-C 0.4%(2/500)and anti-Ec 0.4%(2/500).The positive rate of irregular antibody screening in the pregnant women with first pregnancy in the control group was 0,and the difference between the two groups was statistically significant(P<0.05).Rh-HDN was found in 10 newborns(2%)of the 20 women with positive irregular antibodies in the pregnant women with second child,and the antibody titer during pregnancy was more than 32.No Rh-HDN occurred in newborns in the pregnant women with first pregnancy,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Pregnancy stimulation can increase the probability of irregular antibodies in pregnant women,and irregular antibodies in Rh blood group can easily cause Rh-HDN,so attention should be paid to routine detection of five antigens of Rh blood group and irregular antibody screening during prenatal examination.It is helpful for the early detection of Rh-blood irregular antibodies and the assessment of fetal or neonatal risk of Rh-HDN.

摘要： 目的 探讨ABO及Rh新生儿溶血病(HDN)胎次、黄疸日龄与溶血三项试验的关系,为临床提供诊断治疗依据.方法 以1299例疑似HDN患儿为研究对象,检测母-儿ABO、RhD血型,进行新生儿溶血三项(直接抗球蛋白、游离抗体、抗体释放)试验,统计相关数据.结果 确诊HDN 627例,ABO HDN614例(97.93％),Rh HDN13例(2.07％).ABO HDN:O-A、O-B组发病率分别为72.21％、55.94％,直抗试验阳性率分别为10.41％、4.11％,差异均有统计学意义(P<0.01);一胎、二胎发病率分别为49.57％、72.83％,游离抗体试验阳性率分别为30.67％、50.95％,差异均有统计学意义(P<0.01).ABO HDN黄疸日龄≤3天,阳性率为77.67％,超过8天直抗试验检不出.Rh HDN黄疸患儿出生2小时或21天检测≤3至≥8溶血三项全阳性,呈强凝集反应.结论 ABO HDN发病率较高,二胎高于一胎,A型患儿高于B型;Rh HDN发病率低,严重溶血持续时间长.均应早确诊、早治疗.

摘要： 目的 探讨血型基因测序检测技术在新生儿溶血病(HDN)中的应用.方法 选取院2018年1-12月本院收治的155例母婴血型不合的新生儿及其母亲为研究对象,进行血型基因型检测,并收集相关的临床资料,筛选HDN的危险因素建立预测模型,并评价其在HDN中的应用价值.结果 155例母婴血型不合新生儿HDN的发病率为34.8％.孕妇的血型为O/新生儿血型为A、孕妇非首胎妊娠、既往流产史、产前抗体效价升高、新生儿脐血血红蛋白水平均为预测HDN发生的危险因素.结论 基于ABO血型基因型检测结果及危险因素建立的风险预测模型对HDN有一定的积极意义,可用于指导临床实践.

摘要： 目的 关于母婴ABO血型不合导致的新生儿溶血病(HDN)临床检测探究.方法 选择120 例在我院娩出且检出疑似新生儿HDN的患儿进行研究,采集患儿血液标本,利用血清检测试验进行相关指标检测,明确属ABO溶血后,准确记录分析在新生儿出生后不同时间采血检测出的直接抗人球蛋白试验、游离抗体试验、抗体释放试验结果.结果 全部患儿经过检查,确诊新生儿HDN的例数为103例(85. 83%),出生48h内检出率最高,随着出生时间的延长,检出率逐渐下降,大部分患儿试验结果呈阳性,其中经抗体释放试验检测后阳性率高,部分检测数据比较后有差异,有统计学意义P＜0. 05.结论 ABO溶血新生儿HDN临床检测时,选择在出生2天内进行疾病阳性率检测效果好,其中基于血液血清的抗体释放试验检测阳性结果为患儿疾病确诊的关键标准,如果单一进行了直接抗人球蛋白试验或者游离抗体试验,临床医生要依据检测结果与患儿发病的临床表现来确诊疾病,以期给予患儿及时且有效的治疗,减轻疾病带给患儿的诸多痛苦.

摘要： Objective: To evaluate the outcome of ureteroscopic pneumatic lithotripsy in single lower ureteric calculus and correlate its success with different CT parameters like HU, size of calculus and hydrnephrosis, if present. Patients and Methods: This study was conducted from October 2017 to March 2019 in Department of General Surgery, Maulana Azad Medical College, New Delhi. 30 patients (out of which 6 were excluded due to spontaneous passage of calculus), with single lower ureteric calculus were chosen and the outcome of URSL was compared with respect to CT parameters of Size, HU and Hydronephrosis and intra-operative clearance of calculus. Results: Success rate of URSL in single lower ureteric calculus was found to be 75%. Lower HU (774.12 ± 212.85) was associated with higher success rate. Similarly smaller size of calculus (9 ± 2.1) mm was associated with success group. Patients with gross hydronephrosis had a poor outcome of URSL. Lower urinary tract infection (8.33%) was the most common complication. Conclusion: Patients with small size calculus, low HU and absence of hydronephrosis have a better outcome of URSL.

摘要： 目的:探讨母婴ABO合并Rh血型不合和Rh两座位3位点表型不合HDN实验诊断与鉴别诊断,为临床早期防治提供实验依据.方法:用吸收放散和直抗作为实验诊断,用A-c、B-c和O-c阴性红细胞鉴别诊断,O型Rh-ccdEe、O型Rh-CCDee及A型Rh-CCdee组合谱细胞鉴别两座位多位点表型不合Rh-HDN,盐水法鉴定抗体性质.结果:①母婴ABO/Rh血型:母婴1血型鉴定为O-A及Rh-ccdee/ccDEe交叉不合、母婴2鉴定为A-A及Rh-ccdee/CcDEe两座位3位点表型不合;②抗体筛选:母婴1不规则抗体均为强阳性(4+);母2为不规则抗体强阳性(4+)、婴儿2为阳性(+).③抗体鉴定与鉴别诊断:母1为IgG抗A合并IgG抗D,IgG抗E缺失,IgG抗A效价256,IgG抗D效价128;母2为IgM抗E合并IgG抗D,IgM抗C缺失,IgG为抗D效价128,IgG抗E及抗C缺失.④鉴别诊断:婴儿1证实为IgG抗A合并IgG抗D-HDN;婴儿2证实为Rh抗D-HDN,IgG抗E及抗C缺失.结论:用A-c、B-c、O-c阴性红细胞和Rh单特异性组合谱细胞,可以鉴别诊断ABO合并Rh HDN以及Rh单一性或混合性HDN.

摘要： 目的：了解无锡三院新生儿溶血病（HDN）的发病情况，建立完善的早期产前检查，提高患儿的生存率。方法对2012年9月-2014年1月无锡三院新生儿病房住院患儿临床资料进行回顾性分析，分析男女的发病率，并将其分为正常对照组和 HDN 患儿组，对比相关因素、确诊试验的阳性率。结果101例高度疑似 HDN 新生儿中发病率为24．5％，其中女婴发病率与男婴发病率相似，HDN 患儿的网织红细胞、总胆红素、直接胆红素、间接胆红素四种相关因素的结果均明显高于正常对照组（P ＜0．05）。各种诊断试验中，患儿游离抗体试验、抗体放散试验以及母亲抗体效价（≥1∶128）的检测均有很高的阳性率。结论网织红细胞、胆红素的检测以及患儿红细胞直接抗人球蛋白试验、患儿游离抗体试验、抗体放散试验3种试验对新生儿 HDN 具有诊断性意义。%Objective To comprehend the incidence of hemolytic disease of the newborn(HDN)in the third people's hospital of Wuxi,and establish prenatal examination to improve the survival rates for HDN newborn.Methods Clinical data of newborns in the third people's hospital of wuxi (including the HDN incidence rate of male-female)were retro-spectively analyzed from 2012.9-2014.1.The newborns were fall into HDN group and control group.The positive rates of diagnosis test and related factors were compared.Results 101 cases of suspected HDN neonatal morbidity rate was 24.5%,The incidence was similar between female and male.Four related factors(reticulocyte,total bilirubin,direct bili-rubin,indirect bilirubin)of HDN in HDN group were all significant higher than control group(all P <0.05),and the di-agnostic tests (including children free antibody test,antibody elution test and maternal antibody titer )positive rates were very high.Conclusion Reticulocyte rates,bilirubin level,red blood cells with direct antiglobulin test,children free antibody test and antibody elution test are significant for HDN diagnosis.

摘要： Duffy血型系统是人类重要血型系统之一，主要抗原有Fya和Fyb，抗体可引起致命的新生儿溶血病（HDN）、溶血性输血反应。其中Fyb抗体是少见抗体，易误诊及延误治疗。本研究分析1例由Fyb抗体引起的HDN，以期提高对该病的认识，及时诊治。

摘要： 本发明涉及一株防控腐烂茎线虫的蜡样芽孢杆菌HDN‑1，属于微生物农药技术领域。本发明涉及的菌株HDN‑1，已于2019年10月22日保藏在中国微生物菌种保藏管理委员会普通微生物中心，保藏号为：CGMCC No.18717。室内试验表明，该菌株发酵液原液以及不同稀释梯度下对腐烂茎线虫具有良好的触杀活性。田间试验表明，利用HDN‑1菌株发酵液进行马铃薯种薯拌种处理后，与空白对照相比腐烂茎线虫病的发病率和病情指数显著降低，与化学药剂10％噻唑膦相比无显著差异；同时，马铃薯经蜡样芽孢杆菌HDN‑1发酵液拌种处理后，产量均显著高于药剂对照和空白对照。

摘要： 本发明属于细胞染色以及试剂盒的技术领域，具体涉及一种HDN染色液及其用于辣根过氧化酶特异性显色的试剂盒。所述试剂盒包括HDN染色液，所述HDN染色液包括双氧水、缓冲液、硫酸镍铵、3,3’二氨基联苯胺以及氯化铵；所述试剂盒的免疫组织化学的方法如下：1）取被检活性组织切片，固定；2）用一抗检测欲发现的抗原或抗体；3）染色：将所得组织切片浸入HDN染色液中，待组织切片的阳性检测物呈现深紫蓝色；4）清洗组织切片；5）封片，观察组织切片。采用HDN染色液进行染色，得到的试剂盒的敏感度相比常法高10倍以上，可以显示常法染不出的物质，可以减少假阴性结果，避免漏诊。非阳性物质不染色，可以避免假阳性结果。