新生儿ABO血型不合溶血病是新生儿溶血病的主要类型,约占整个新生儿溶血病的80%。40%~50%ABO溶血病见于第一胎,病情相对较轻或无症状而不易被察觉。重症者可在24小时内出现黄疸,3~5天达高峰;但胎儿水肿、肝脾肿大及流产者均少见。ABO溶血病最多见于母亲为O型、胎儿为A型或B型。第1胎即可发病,通常发病较轻。但随着分娩次数增加,发病率会相应增高,病情相对严重,其原因为O型母亲可自发性地产生抗A或抗B的IgG抗体。据统计,孕妇与胎儿发生ABO血型不合的概率为20%~25%,而其中发生溶血病的概率仅为10%左右。
ABO血型不合的双亲,其子代Rh溶血病的发生率低,原因为主要血型抗原不配合,使胎儿血在母体内很快被抗A或抗B凝集素所破坏,从而降低Rh抗原的致敏作用,减少Rh溶血病的发生机会。
ABO溶血病大多不需特殊治疗。如果黄疸和贫血较严重,可行换血治疗和光疗(见Rh溶血病的治疗)。ABO溶血病一般病情较轻,病程为一过性,预后良好。
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