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近40年来溶血病的治疗有了巨大进展,围产期新生儿溶血病的死亡率明显下降。Rh预防疗法已使出生婴儿的Rh致敏率降至6/10万,但严重溶血病的治疗仍很严重。 在病因学方面,1941年Lerine等证实同族免疫是新生儿溶血病的主要原因,Cheun认为胎儿红细胞可经胎盘途经致母体发生间接免疫,首次妊娠抗体形成率为0.35～1.9％,而再次妊娠时可又增加11.5％。抗体可经胎盘进入胎儿循环,抗—DIgG抗体致敏胎儿红细胞,使之与单核细胞/巨噬细胞上的lgGFc受体结合,发生噬红细胞性或细胞毒性溶血,导致胎儿发病。
The treatment of hemolytic disease has made tremendous progress in the past 40 years, and the mortality rate of perinatal neonatal hemolytic disease is obviously decreased. Rh prophylaxis has reduced the Rh sensitization rate of newborns to 6 / 100,000 but the treatment of severe hemolytic disease remains severe. In terms of etiology, Lerine et al. Confirmed the congenial immunization in 1941 as the major cause of hemolytic disease in newborns. Cheun thought that indirect immunization of fetal erythrocytes via placenta could result in maternal infection with antibody formation rate of 0.35-1.9% for the first time, while in the second pregnancy Can increase 11.5% again. Antibodies can enter the fetal circulation through the placenta, anti-DIgG antibody sensitized fetal red blood cells, monocytes / macrophages lgGFc receptor binding, the occurrence of erythroid or cytotoxic hemolysis, leading to fetal disease.