【摘要】 目的 了解抗-Mur引起的新生儿溶血病血清学特征及临床意义。方法 采用血清学方法对1名患儿及其父母的血样做ABO与Rh血型鉴定，对患儿和母亲的血样做抗体筛查和鉴定，对患儿血样做直接抗球蛋白试验、游离和放散试验。采用PCR-SSP方法对患儿及其父母的血样做MUR基因检测。结果 患儿及其母亲和父亲的血型分别为A型DCCee Mur+、A型DCCee Mur–、A型DCCee Mur+；在母亲血清中检出IgM-Mur和IgG-Mur抗体，患儿血清和放散液中检出IgG-Mur抗体，母亲血清、患儿血清和放散液IgG-Mur效价分别为128、32、64。患儿直接抗球蛋白试验、游离和放散试验均为阳性。患儿出生后出现黄疸，最高胆红素达221.9??μmol/L，给予蓝光治疗和输注人免疫球蛋白后黄疸逐渐消退。结论 新生儿溶血病检测中当母亲及患儿抗体筛查为阴性，患儿直接抗球蛋白为阳性且临床有溶血表现时，需考虑是否有抗-Mur等低频抗体的存在。实验室应采用包含稀有抗原的谱细胞进行抗体鉴定，并结合分子分型技术，以避免漏检，保障母婴安全。更多还原

【Abstract】 Objective To investigate the serological characteristics and clinical significance of hemolytic disease of newborn (HDN) caused by the anti-Mur antibody.Methods ABO and Rh blood group typing were done on blood samples from one neonate and their parents.Antibody screening and identification were performed on the blood samples of the neonate and the mother.The neonate’s blood sample were subjected to direct antiglobulin test (DAT),serum antibody identification,and elution antibody identification.PCR-SSP was used for MUR gene detection in the blood samples from the neonate and parents.Results The blood types of the neonate,mother,and father were A DCCee Mur+,A DCCee Mur–,and A DCCee Mur+,respectively.IgM-Mur and IgG-Mur antibodies were detected in the mother’s serum,while IgG-Mur antibody was found in both the neonate’s serum and the elution.The IgG-Mur titers in the mother’s serum,the neonate’s serum,and the elution were 128,32,and 64.The neonate’s DAT,serum antibody screen,and elution screen were all positive.Jaundice occurred in the infant shortly after birth,with the bilirubin level peaking at 221.9??μmol/L,and the jaundice gradually subsided following treatment with phototherapy and intravenous administration of human immunoglobulin.Conclusion In cases of hemolytic disease of newborn test,if antibody screening is negative for both the mother and the neonate,but the neonate’s DAT is positive and there are clinical signs of hemolysis,the possibility of low-frequency antibodies,such as anti-Mur,should be considered.Laboratories are encouraged to use panel cells containing rare antigens for antibody identification and combine molecular typing technology to prevent missed diagnoses and ensure the safety of both mother and neonate.更多还原