A Comparative Analysis of the Efficacy of Blood Exchange Therapy in Neonatal Hyperbilirubinemia Induced by ABO and Rh Incompatibility.

IF 2.1 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of General Medicine Pub Date : 2024-12-09 eCollection Date: 2024-01-01 DOI:10.2147/IJGM.S497184
Kunhai Wu, Lufei Chen, Huifang Huang, Dengkai Chen
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Abstract

Background: This study challenges the prevailing view that hemolytic diseases of the newborn (HDN) associated with the Rh blood group system are more severe than those caused by the ABO system. The objective was to assess the effectiveness of exchange transfusion (ET) in managing HDN, with a focus on comparing treatment outcomes between ABO and Rh incompatibility cases.

Methods: A study enrolled 125 neonates diagnosed with hyperbilirubinemia, comprising 66 males and 59 females. The gestational age of the neonates ranged from 33 to 41 weeks, and their birth weights varied between 2.11 to 4.3 kilograms. Based on the etiology of hemolysis, the study categorized 73 cases as ABO group and 52 as Rh group.

Results: Post- ET, there was a significant reduction in serum total bilirubin (STB), serum indirect bilirubin (SIB), and platelet (PLT) counts (P<0.001). Pre- ET, differences in SIB and PLT were noted between neonates with ABO and Rh incompatibilities (P<0.05). There was no statistically significant disparities in the therapeutic effects of ET on STB, SIB, and PLT levels when comparing male and female neonates across both the ABO and Rh incompatibility groups.

Conclusion: Our study demonstrated that ET is efficacious in reducing bilirubin levels and platelet counts in neonates presenting with ABO and Rh blood group incompatibilities. Notably, the effectiveness of ET was found to be independent of the neonates' gender, a finding that underscores the universal applicability of this treatment approach. Our study observation contradicts the prevalent belief that HDN associated with the Rh system is inherently more severe than that linked to the ABO system. This revelation underscores the imperative for the swift implementation of ET in managing cases of severe hyperbilirubinemia.

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血液交换治疗ABO、Rh血型不合致新生儿高胆红素血症的疗效比较分析。
背景:本研究挑战了流行的观点,即与Rh血型系统相关的新生儿溶血性疾病(HDN)比ABO血型系统引起的新生儿溶血性疾病更严重。目的是评估交换输血(ET)治疗HDN的有效性,重点是比较ABO和Rh不相容病例的治疗结果。方法:一项研究纳入125名诊断为高胆红素血症的新生儿,包括66名男性和59名女性。这些新生儿的胎龄在33到41周之间,出生体重在2.11到4.3公斤之间。根据溶血的病因,本研究将73例患者归为ABO组,52例归为Rh组。结果:ET治疗后,血清总胆红素(STB)、血清间接胆红素(SIB)和血小板(PLT)计数显著降低。结论:我们的研究表明,ET对ABO和Rh血型不相容的新生儿胆红素水平和血小板计数有效。值得注意的是,ET的有效性与新生儿的性别无关,这一发现强调了这种治疗方法的普遍适用性。我们的研究结果与普遍认为与Rh系统相关的HDN本质上比与ABO系统相关的HDN更严重的观点相矛盾。这一发现强调了在管理严重高胆红素血症病例中迅速实施ET的必要性。
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International Journal of General Medicine
International Journal of General Medicine Medicine-General Medicine
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期刊介绍: The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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