ABSTRACT
【Objective】 To analyze the yield, specificity and detection time of red blood cell(RBC)alloimmunization in 104 588 inpatients. 【Methods】 The clinical information of patients who underwent at least one antibody screening in our hospital from November 2017 to December 2019 was retrospectively analyzed. The demographic characteristics, transfusion history, pregnancy history and antibody screening results of patients were collected. The RBC alloantibody yield, specificity and detection time were analyzed, and differences of transfusion units and frequency between patients with and without alloimmunization were compared. 【Results】 Eight hundred cases of alloantibodies with clinical significance were detected in blood samples of 723 patients, with a positive rate of 0.7% (723/104 588). The incidence rate of alloimmunization in females was higher than that in males (0.9% vs 0.5%, P<0.05). Rh alloantibodies accounted for 76.4%(611/800), of which 61.4%(375/611)were anti-E. Transfusion units and frequency of patients with alloimmunity were higher than those without(median: 6.0 vs 4.0, P<0.05; 4.0 vs 2.0, P<0.05, respectively). And 67.5% of RBC alloantibodies were detected within 6 months, with the median (IQR) detection time of 97.0 (22.5-247.0) days. 【Conclusion】 Routine antibody screening should be performed before transfusion in order to reduce the occurrence of adverse reactions, and Rh typing transfusion with compatible crossmatch should be performed if necessary.
ABSTRACT
【Objective】 To analyze ABO system hemolytic disease of the fetus and newborn (HDFN) and its influencing factors in Obstetrics Department of our hospital. 【Methods】 The blood samples of 1 040 neonates and their mothers in the obstetric department of our hospital were retrospectively analyzed from September 2022 to January 2023, including ABO and RhD blood group of the neonates and mothers, as well as 3 tests of HDFN, Hb, total bilirubin (TBIL) and indirect bilirubin(IBIL) of the neonates. Relevant clinical data of the neonates and mothers were collected, including maternal and neonatal age, neonatal sex, maternal pregnancy history, gestational age and delivery mode, and their influences on ABO-HDFN were analyzed. 【Results】 Among 1 040 HDFN samples, 298 were ABO incompatibility, among which 113 were HDFN positive, with a positive rate of 37.9% (113/298); the positive rate of HDFN in neonates born to mothers with type O was significantly higher than that in neonates born to mothers with type A and B (71.4% vs 8.2%, P<0.05); the positive rate of HDFN in neonates with antigen-A incompatibility was significantly higher than that in neonates with antigen-B incompatibility (48.7%vs 26.7%, P<0.05), which was the highest in neonates with O-A incompatibility [83.6% (61/73)], followed by O-B incompatibility [58.2% (39/67)]. There was no significant difference in Hb and bilirubin among the other groups except for the difference of Hb between the O-A incompatibility HDFN positive group and the HDFN negative group [(145.0±16.0) vs(153.4±13.2), P<0.05)]. The levels of Hb, TBIL and IBIL in the "direct antiglobulin test+ indirect antiglobulin test+release test+" group were significantly different from those in the HDFN negative group[(144.9±21.6) vs (153.3±13.2), P <0.05; (36.9±11.8) vs (29.6±6.1), P<0.05; (30.6±12.7) vs (23.0±6.9), P<0.05, respectively]. Logistic regression analysis showed that maternal delivery frequency, mother-neonate incompatible antigen and maternal blood type were independent risk factors for HDFN. 【Conclusion】 ABO-HDFN occurred mainly in neonates born to O-type mothers, and the positive rate was the highest in neonates with O-A incompatibility. The severity of HDFN had little relationship with the mother-neonate blood type, but had relationship with the result of 3 tests of HDFN. Maternal delivery frequency, mother-neonate incompatible antigen and maternal blood type were independent risk factors for HDFN.
ABSTRACT
Objective:To explore the clinical therapeutic effect of simvastatin combined cyclic adenosine monophos-phate on coronary heart disease (CHD)with chronic heart failure (CHF)and levels of serum-related factors.Meth-ods:A total of 78 CHD patients with CHF hospitalized in our hospital from Jan 2011 to Jan 2012 were selected. They were randomly and equally divided into simvastatin group and combined treatment group using number table, both groups received routine treatment,simvastatin group received simvastatin in addition, while combined treat-ment group received cyclic adenosine monophosphate based on simvastatin group.Therapeutic effect,changes of cardiac function indexes and serum factor levels were compared between two groups before and after treatment.Re-sults:The total effective rate of combined treatment group (92.31%)was significantly higher than that of simvasta-tin group (71.79%),P<0.05;compared with before treatment and simvastatin after treatment,there were signifi-cant rise in left ventricular ejection fraction [LVEF,(33.54±3.34)%,(43.41±3.23)% vs.(55.21±3.45)%] and transmitral early/late diastolic peak flow velocity [E/A,(0.63±0.11),(0.70±0.15)vs.(1.01±0.21)],and significant reductions in levels of brain natriuretic peptide [BNP,(536.74±21.41)ng/ml,(117.23±11.57)ng/ml vs.(78.20±10.92)ng/ml]and C reactive protein [CRP,(24.00±2.34)mg/L,(17.01±1.09)mg/L vs.(8.28± 0.81)mg/L]in combined treatment group,P<0.05~<0.01.Conclusion:Simvastatin combined cyclic adenosine monophosphate possess significant therapeutic effect on chronic heart failure of coronary heart disease,it can signif-icantly improve cardiac function and serum factor levels in CHD patients with chronic heart failure,and possess good clinical application value.