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目的 探讨新生儿高胆红素血症患儿使用葡萄糖-6-磷酸脱氢酶(glucose 6-phosphate dehydrogenase,G6PD)活性低的库存血对换血治疗效果的影响.方法 选择2017年1月至2018年12月南宁市妇幼保健院新生儿科采取换血治疗的新生儿高胆红素血症息儿进行前瞻性研究,换血前采集患儿和库存血血样检测G6PD活性,根据新生儿G6PD活性分为新生儿G6PD活性正常组和新生儿G6PD活性低组,每组再根据库存血G6PD活性分为库存血G6PD活性正常组和库存血G6PD活性低组.分析各组患儿住院时间、换血后光疗时间、换血后血清总胆红素(serum total bilirubin,TSB)下降情况.结果 共纳入99例,新生儿G6PD活性正常组共51例,其中库存血G6PD活性低组(27例)TSB下降百分率低于库存血G6PD活性正常组(24例)[(56.9±8.4)％比(72.5±14.4)％],住院时间和光疗时间长于库存血G6PD活性正常组[(6.4±2.3)d比(4.9±1.3)d,(70.8±36.2)h比(52.3±16.3)h],差异有统计学意义(P＜0.05).新生儿G6PD活性低组共48例,其中库存血G6PD活性低组(26例)TSB下降百分率低于库存血G6PD活性正常组(22例)[(58.8±6.2)％比(67.3±13.9)％],住院时间和光疗时间长于库存血G6PD活性正常组[(5.5±2.2)d比(4.4±1.4)d,(60.6±25.9)h比(47.9±27.9)h],差异有统计学意义(P＜0.05).库存血G6PD活性对换血治疗的高胆红素血症患儿光疗时间(F=7.695,P=0.007)、住院时间(F =12.528,P=0.001)、TSB下降百分率(F =29.025,P＜0.001)有影响.结论 使用G6PD活性低的库存血进行换血治疗会影响治疗效果,导致换血后TSB下降减少,光疗时间和住院时间延长.“,”Objective To study the effects of stored blood with low glucose 6-phosphate dehydrogenase (G6PD) activity for exchange transfusion (ET) in neonate hyperbilirubinemia.Method From January 2017 to December 2018,all neonates receiving ET for neonatal hyperbilirubinemia in neonatology department of our hospital were prospectively enrolled.G6PD activity in stored blood and in these neonates were examined.Their demographic information and other clinical data including post-ET total serum bilirubin (TSB) decrease,post-ET phototherapy duration and total hospital stay duration were collected.Result A total of 99 cases were enrolled,51 cases with normal G6PD and 48 G6PD deficiency.Among normal G6PDneonates,those receiving low G6PD activity blood had less decrease of post-ET TSB [(56.9 ± 8.4) ％ vs.(72.5 ± 14.4) ％],longer hospital stay and longer post-ET phototherapy duration [(6.4 ± 2.3) d vs.(4.9 ± 1.3) d,(70.8 ± 36.2) h vs.(52.3 ± 16.3) h] (P ＜ 0.05) than those receiving normal G6PD blood.Among G6PD deficiency neonates,those receiving low G6PD activity blood had less decrease of post-ET TSB [(58.8 ±6.2)％ vs.(67.3 ± 13.9)％],longer hospital stay and longer post-ET phototherapy duration [(5.5 ± 2.2) d vs.(4.4 ± 1.4) d,(60.6 ± 25.9) h vs.(47.9 ± 27.9) h] (P ＜ 0.05) than those receiving normal G6PD blood.The G6PD activity in stored blood had significant influences on duration of phototherapy (F =7.695,P =0.007),duration of hospital stay (F =12.528,P =0.001) and decrease of post-ET TSB (F =29.025,P ＜ 0.001).Conclusion ET with low G6PD activity stored blood has less favourable effects with less post-ET TSB decrease and prolonged duration of phototherapy and hospital stay.