ABO新生儿溶血病患儿血浆中血管细胞粘附分子-1的表达差异与意义*

doi:10.3969/j.issn.1671-2587.2024.06.005

临床输血与检验 ›› 2024, Vol. 26 ›› Issue (6): 744-749.DOI: 10.3969/j.issn.1671-2587.2024.06.005

ABO新生儿溶血病患儿血浆中血管细胞粘附分子-1的表达差异与意义^*

沈倩云^1,2, 程文国², 侯书宁², 姚根宏¹

¹南京医科大学鼓楼临床医学院风湿免疫科,江苏南京 210000;
²扬州市妇幼保健院（扬州大学医学院附属扬州妇幼保健院）检验科,江苏扬州 225002

收稿日期:2024-04-23 出版日期:2024-12-20 发布日期:2024-12-20
通讯作者: 姚根宏,主要从事输血免疫及自身免疫疾病等方面的研究,（E-mail）yaogenhong@nju.edu.cn。
作者简介:沈倩云,主要从事输血免疫方面研究,（E-mail）shenqianyun1987@126.com。
基金资助:
*本课题受国家自然科学基金（No.81970062）、南京市医学科技发展资金项目（No.ZKX21027）资助

Differential Expression and Clinical Significance of Vascular Cell Adhesion Molecule-1 in Plasma of Neonates with ABO Hemolytic Disease

SHEN Qianyun^1,2, CHENG Wenguo², HOU Shuning², YAO Genghong¹

¹Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210001;
²Department of Clinical Laboratory, Yangzhou Maternal and Child Health Hospital, Affiliated Hospital of Medical School of Yangzhou University, Yangzhou, Jiangsu 225002

Received:2024-04-23 Online:2024-12-20 Published:2024-12-20

摘要/Abstract

摘要： 目的检测ABO新生儿溶血病（hemolytic disease of newborn, HDN）患儿的血浆血管细胞粘附分子1（vascular cell adhesion molecule 1, VCAM-1）水平,预测ABO-HDN患儿内皮受损程度及体内溶血情况。方法回顾性收集了2022年6月—2023年6月就诊于我院的127例ABO-HDN患儿一般资料及外周血标本,分为轻度、中度和重度高胆红素血症组3个亚组;设127例母婴血型匹配的健康新生儿作为健康对照组及非溶血性黄疸对照组41例。通过溶血三项试验明确ABO-HDN诊断,检测所有样本血型以及不规则抗体,酶联免疫吸附法检测血浆中VCAM-1浓度,并获取其一般临床信息和实验室检查结果。结果单因素分析对比分析ABO-HDN组与健康对照组新生儿的性别、出生体重、血型、其母亲的分娩方式、有无胎膜早破,差异无统计学意义（P>0.05）。新生儿胎龄、母亲年龄及妊娠次数存在差异（P<0.05）;比较三实验组的血红蛋白（hemoglobin, Hb）、乳酸脱氢酶（lactate dehydrogenase, LDH）、间接胆红素（indirect bilirubin, IBIL）、网织红细胞（reticulocyte, Ret）、超敏C-反应蛋白（high-sensitivity C-reactive protein, hs-CRP）及VCAM-1水平存在差异（P<0.05）,且VCAM-1水平与LDH、IBIL、Ret水平呈正相关,而与Hb水平呈负相关（P<0.05）。ABO-HBN组VCAM-1水平与Hb、Ret、IBIL、LDH水平呈现独立相关性（P<0.05）;三个亚组中重度高胆红素血症组VCAM-1水平明显高于轻度和中度高胆红素血症组（P<0.05）。结论 ABO-HDN患儿VCAM-1升高可能与血管内皮受损相关,并有助于评估疾病的溶血严重程度。

关键词: ABO新生儿溶血病, 血管内皮损伤, 血管细胞粘附分子1

Abstract: Objective Detecting the plasma vascular cell adhesion molecule 1 (VCAM-1) level in neonates with ABO hemolytic disease (HDN), to predict the degree of endothelial damage and in vivo hemolysis in ABO-HDN children. Methods A total of 127 cases of ABO-HDN attending our hospital between June 2022 and June 2023 were retrospectively collected, and further divided into three subgroups, namelymild, moderate, and severe hyperbilirubinemia. 127 healthy newborns with matching maternal and infant blood groups were recruited as a healthy control group. 41 cases of non-hemolytic jaundice were set up as the control group. A triple hemolytic test clarified the diagnosis of ABO-HDN, and all samples were tested for blood type and irregular antibodies. Plasma VCAM-1 were determined by enzyme-linked immunosorbent assay. Results 1 There was no statistically significant difference between the ABO-HDN group and the healthy control group regarding the sex of the newborns, birth weight, blood type, mode of delivery of their mothers, and the presence or absence of preterm rupture of membranes (P>0.05), and the neonatal gestational age, maternal age, and number of pregnancies showed significant differences between the two groups (P<0.05). There were differences in hemoglobin (Hb), reticulocyte (Ret), indirect bilirubin (IBIL), lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hs-CRP) and plasma VCAM-1 (P<0.05, and the levels of VCAM-1 were positively correlated with the levels of LDH, IBIL, and Ret, and negatively correlated with the levels of Hb (P<0.05). VCAM-1 levels in the ABO-HBN group showed independent correlations with Hb, Ret, IBIL, and LDH levels (P<0.05). Among the three subgroups, VCAM-1 levels were significantly higher in the severe hyperbilirubinemia group than in the mild and moderate hyperbilirubinemia groups (P<0.05). Conclusion Elevated VCAM-1 in children with ABO-HDN may be associated with vascular endothelial damage and with help in assessing the severity of hemolysis in the disease.

Key words: ABO hemolytic disease of the newborn, Vascular endothelial injury, Vascular cell adhesion molecule 1

中图分类号:

R457

沈倩云, 程文国, 侯书宁, 姚根宏. ABO新生儿溶血病患儿血浆中血管细胞粘附分子-1的表达差异与意义^*[J]. 临床输血与检验, 2024, 26(6): 744-749.

SHEN Qianyun, CHENG Wenguo, HOU Shuning, YAO Genghong. Differential Expression and Clinical Significance of Vascular Cell Adhesion Molecule-1 in Plasma of Neonates with ABO Hemolytic Disease[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2024, 26(6): 744-749.

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ABO新生儿溶血病患儿血浆中血管细胞粘附分子-1的表达差异与意义^*

Differential Expression and Clinical Significance of Vascular Cell Adhesion Molecule-1 in Plasma of Neonates with ABO Hemolytic Disease

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