摘要
目的 自身免疫溶血性贫血（autoimmune hemolytic anemia，AIHA）是一种由体内免疫功能调节紊乱导致的溶血性贫血，其特征是自身抗体和（或）补体吸附于红细胞表面，通过抗原抗体反应加速红细胞破坏。本文通过分析3例典型自身免疫溶血性贫血病例，结合相关文献复习，探讨该病的临床表现、诊断方法、治疗策略及预后因素，以期为临床医生提供参考。方法 根据我院新生儿科3例AIHA病例治疗经验分享及文献复习。结果 随访3例患儿，2例发育良好，1例死亡。结论 动静脉同步部分换血或血浆置换可快速换出致敏红细胞，换血后给予免疫球蛋白、激素或利妥昔单抗输注，可显著减轻免疫反应。
关键词： 免疫；溶血；贫血；黄疸；动静脉同步换血
Abstract
Objective: Autoimmune hemolytic anemia (AIHA) is a hemolytic anemia caused by immune dysfunction in the body, characterized by the adsorption of autoantibodies and/or complement to the surface of red blood cells, accelerating their destruction through antigen antibody reactions. This article analyzes three typical cases of autoimmune hemolytic anemia and reviews relevant literature to explore the clinical manifestations, diagnostic methods, treatment strategies, and prognostic factors of the disease, in order to provide reference for clinical doctors. Methods: Based on the sharing of treatment experience and literature review of 3 cases of AIHA in the neonatology department of our hospital. Results: Follow up of 3 children, 2 developed well and 1 died. Conclusion : Arterial venous synchronous partial exchange transfusion or plasma exchange can quickly exchange sensitized red blood cells. After exchange transfusion, administering immunoglobulin, hormones, or rituximab infusion can significantly reduce immune response.
Key words： Immunity; Hemolysis; Anemia; Jaundice; Arterial venous synchronous exchange transfusion
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