RESUMO
【Objective】 To investigate the clinical and genetic characteristics of hemolytic disease of the newborn(HDN) induced by anti-M complicated with pyruvate kinase deficiency (PKD) disease. 【Methods】 The clinical data of a pregnant woman with unexplained adverse pregnancy outcome in the third trimester were retrospectively analyzed, and neonate anemia status and blood transfusion were followed up. With informed consent, peripheral blood of the neonate and her parents were collected for serological tests and disease-related gene target sequence capture and sequencing. The clinical and genetic characteristics of HDN induced by anti-M or PKD were reviewed. 【Results】 The neonate presented severe anemia, hepatosplenomegalism, hyperbilirubinemia at birth, and was confirmed MN combined with ABO neonatal hemolysis by serological tests. The neonate recovered by receiving blood exchange and phototherapy treatments, but he needed to receive blood transfusion each month because of hemolytic anemia. Genetic analysis showed that the neonate had compound heterozygous mutations (c. 1096C>T; c. 941T>C) of PKLR gene inherited from her parents. 【Conclusion】 The clinical manifestations of PKD are similar to that of HDN caused by anti-M in the early stage of the disease. Clinicians should exclude the metabolic diseases of red blood cells when diagnosing severe HDN caused by anti-M.
RESUMO
Objective To analyze treatment of tubal interstitial pregnancy with Guizhi Fuling pill assisted with methotrexate and mifepristone.Methods 90 cases tubal interstitial pregnancy patients from January 2015 to June 2016 were grouped by admission order and each group with 45 cases.Methotrexate and mifepristone therapy were given the control group,Guizhi Fuling pill assisted with methotrexate and mifepristone were given the observation group.Treatment success rate,β-HCG negative time,mass disappearance time,length of hospitalization and adverse reactions were compared.Results (After treatment,treatment success rate of observation group was 91.11％and 80.49％of tubal smooth,witch all higher than control group with(88.89％,77.50％),but the difference was not statistically significant.(For the treatment of two groups of patients with success,β-HCG negative time,mass disappearance time and length of hospitalization of observation group were(13.05±1.08,24.09±1.43,15.37±0.82)days,shorter than control group with(17.39±1.50,27.43±2.19,18.85±1.)days(P<0.05).③ During treatment,adverse reactions of observation group was 11.11％,lower than control group with 26.67％(P<0.05).Conclusion Guizhi Fuling pill assisted with methotrexate and mifepristone can shorten treatment time and reduce side effects for tubal interstitial pregnancy patients.