在胎盤膜的阻隔下,胎兒與母親各自有著自己的血液循環系統。雖然各自的血液不會混和在一起,但氧氣、營養、代謝物及某幾種類別的抗體卻能夠通過胎盤網的微孔,互相在母子母女之間作出交換。500Please respect copyright.PENANALEXmQ31M75
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在母親懷孕的時期,其自身的一部份抗體將會經由胎盤傳送到胎兒的循環系統裡頭,為他或她抵禦外來物種的侵襲;500Please respect copyright.PENANA7MSuVk5id2
胎兒的免疫系統在母體裡頭並未能夠發展得盡善盡美的關係,母親的協助是非常重要的。500Please respect copyright.PENANA6NGqt5RPXN
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這種無私的幫助看起上來的確非常美好,但無奈魔鬼在細節,當中亦牽伸出一個重要的問題ㄧ500Please respect copyright.PENANALzVCKDbzxN
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抗體的母嬰利益輸送,無形間造就了母體的抗體攻擊胎兒紅血球的契機,引起醫學界所稱為的「新生兒溶血症」(Hemolytic disease of the newborn,HDN)。500Please respect copyright.PENANAB7HxMByZ7w
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新生兒溶血症的嚴重性取決於胎兒紅血球被收抗體所攻擊的程度,若果被幹掉的紅血球數量並不算多的話,胎兒通常均能自我抵禦得住,當中有機會產生輕微貧血或黃疸症狀,情況不太嚴重的話並不需要作出任何治療。500Please respect copyright.PENANAAQAw0RIlOY
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但是,若果紅血球被過量分解的話,身體裡頭的膽紅素便會不斷的積聚下來。胎兒若果還在母體的話,膽紅素尚可經由胎盤透過血液系統傳遞到母親的肝臟裡頭作出分解,由母親為孩兒作出分擔。500Please respect copyright.PENANAyg0o3O1jmx
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若胎兒脫離母體,尤其是在出世後首二十四小時裡頭發生紅血球被過量分解情況的話,情況就真的是不堪設想;500Please respect copyright.PENANA8LTUv2Etgn
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胎兒肝臟在初出世的期間並沒有足夠的能力分解過多的膽紅素,膽紅素的血液濃度會逐漸的增加,最終更會進入腦部,做成永久性的神經損毀。500Please respect copyright.PENANAvfK2rfKH2K
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在新生兒溶血症方面,Rh系統的D antigen對比於ABO系統的H antigen顯得較為重要。500Please respect copyright.PENANA9wMyqMQ7Ek
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主要的原因分別有兩個,第一就是胎兒紅血球上的H antigen數量比成人紅血球為顯注的少,故此不太容易會觸發免疫反應。500Please respect copyright.PENANA25fdQd58SU
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第二就是ABO系統的H antigen並不局限於在紅血球,在胎兒各種表皮及內膜的細胞上均能找到H antigen,因此母體的H antigen抗體遇上胎兒紅血球上的H antigen機會亦相對地大大減少;500Please respect copyright.PENANAYkzYBTSv6l
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相反,Rh系統的D antigen只會在紅血球上找到,其他器官及細胞並不存在D antigen,母體的D antigen抗體將會針對性的攻擊胎兒紅血球。500Please respect copyright.PENANAtRNuIGs5n0
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正因如此,在絕大多數的情況下,新生兒溶血症引致的致命情況均是由母體及胎兒的Rh系統不相容引起的。500Please respect copyright.PENANAQkEtK7xDHe
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(亞洲人的族裔,約只有百分之二的人口持有Rh負血型。)500Please respect copyright.PENANAFVjLjzeTlx
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「克BB,我血型是A-哦,你呢?」500Please respect copyright.PENANA39VkC7xJKZ
得悉Rh正負系統的重要性後,坐在席上的一位女生跟在旁的男同學嬌嗲的說了起來。500Please respect copyright.PENANAEaKZmlaS8O
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「我是B+....」500Please respect copyright.PENANAs22VHwmALs
那名姓克的男生單手拿著捐血卡,神態自若的說著。500Please respect copyright.PENANA2qmevqlHha
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「吓.....? 正? 為甚麼你會這樣不差氣的?500Please respect copyright.PENANA3aBCvgMLtM
我很喜歡小孩子的哦,那怎樣辦呀,BB?」500Please respect copyright.PENANAj61SjSKWyi
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女生負(沒有D antigen),男生正(有D antigen),嬰兒便有機會是正(50或100%有D antigen)。500Please respect copyright.PENANAFe2ceV0xJ1
女生本身的紅血球沒有D antigen,嬰兒紅血球上的D antigen便會被視作為外來之物,被母體的免疫系統攻勢,引發新生兒溶血症出現的可能性; 那名女生是這樣的想著。500Please respect copyright.PENANAbl1RT3fZQJ
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「喂,靚女,我姓馬,血型B-,名副其實是你的駙馬呢!500Please respect copyright.PENANAVAUpXK8Jww
有沒有興趣下課後一起看電影,互相了解一下對方?」500Please respect copyright.PENANAZzKuKt5BTg
那名女生身後的一名男生,洋洋得意不知羞恥的作出搭訕起來。500Please respect copyright.PENANATJumD028Zx
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女生負(沒有D antigen),男生負(沒有D antigen),嬰兒便一定會是負(沒有D antigen),新生兒溶血症的發生機會亦因而大大減低。500Please respect copyright.PENANAJFAilMvC4a
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「我對克BB的愛並不會因為這些正正負負影響得到的,你別痴心妄想啦!」500Please respect copyright.PENANAGaaoV1lp4W
那名女生大聲的作出責罵後,隨即窩在那名男生的懷中,展示出自己的恩愛。500Please respect copyright.PENANAEG9PhG439F
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「唉,你也不是我的伯樂嗎....?500Please respect copyright.PENANAkSNoxo223y
世間上的伯樂全都死掉了嗎?500Please respect copyright.PENANAeDcFx4UcTO
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我這隻絕世好馬,究竟應如何在這亂世中自處呢,天呀!」500Please respect copyright.PENANADNJrkiSZme
那名姓馬的男生右手撥了一下頭上時髦的「花倫同學」的髮型,一臉恨鐵不成鋼的模樣。500Please respect copyright.PENANA28qIRieL2K
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「其實,第一胎出現新生兒溶血症的機率應該是相對的較低吧!500Please respect copyright.PENANA0F2Z6YY9Jf
再加上現今科技如此先進,一定會有方法解決Rh正負所引起的問題!」500Please respect copyright.PENANAPjAjK5sOit
姓克的那位男生托了一下眼鏡,用著安慰的語氣對著那名女生說了起來。500Please respect copyright.PENANAxuAjLwd9Mp
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馬同學、克同學及其在旁女生的對話,血時均聽得一清二楚。500Please respect copyright.PENANAND1h6w24Fi
對於克同學的見解,血時可是非常的認同。500Please respect copyright.PENANAJAZpl3QD4J
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「這位男同學說得一點也沒有錯!」500Please respect copyright.PENANAmHK3eUiOdT
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胎兒和母體的血液循環系統均是獨立的個體,胎兒的紅血球在正常情況下是不會進入母體血液循環裡頭的。500Please respect copyright.PENANA2Y2k4pbiPg
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在Rh血型為負的母親來說,除非曾經在輸血過程中接受過擁有D antigen的血液,否則在自身的血液裡頭間理應是不會存有D antigen的抗體;500Please respect copyright.PENANAQFpvRtYVSg
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這亦是Rh系統和ABO系統其中一種不同的地方,ABO的H antigen和天然間所存在的糖分結構非常相似。長久接觸底下,正常人體的血液均存在著對應的H antigen抗體。500Please respect copyright.PENANAfHAKLJlOxb
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雖則胎盤阻隔著母子的血液循環系統,但在母親產下第一胎的期間,過程中將會有很大的機會與胎兒的血液接觸。500Please respect copyright.PENANA0EtcPZ1G7l
若胎兒為Rh正而母親為Rh負的話,這便會觸發母親體內D antigen抗體的產生;500Please respect copyright.PENANAi1BwWTGTXY
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只不過,若果母親的ABO血型與胎兒的ABO血液不吻合的話,母親體內的H antigen抗體將會快速消除胎兒的紅血球,這時候D antigen暴露於母體免疫系統的機會亦會相對減低,有機會可以避免D antigen抗體的產生。500Please respect copyright.PENANA682QmUvJCa
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無論如何,這些由第一胎臨盤而產生出來的D antigen抗體,將會有很大的機會影響第二胎Rh正的胎兒。500Please respect copyright.PENANATXcoYegdHs
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不過不用害怕,現今醫療科技發達,醫生均有著各種手段檢查胎兒的狀況,亦有各種方法檢測母體及胎兒的ABO及Rh血型。500Please respect copyright.PENANA7rvzWXAE30
在某幾種情況下更會為母親注入D antigen的抗體,避免母親接觸到外來的D antigen,必要時更可為在母體內的胎兒輸血,更換死去的紅血球細胞。500Please respect copyright.PENANA6prf0EVaxG
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因Rh系統不吻合而不能作出敦倫的情況,在現今的社會上是不會發生的。500Please respect copyright.PENANAoG9Nlush83
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鈴...鈴...鈴.....500Please respect copyright.PENANAteQbeCpgSn
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講解的時間過得特別快,說到Rh血液系統的時候下課鐘聲亦恰巧的響起。500Please respect copyright.PENANAWudag5b80V
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血時迅速的收拾個人物品,啪啪聲的關上電腦,比在座的學生們更快的離開演講廳。500Please respect copyright.PENANAdxfXidhJHR
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「血..血時教授...」500Please respect copyright.PENANAnI6Ug3o6hj
那名為茱燕的女同學本意是在下課的時候找血時商量一些事情的,奈何血時的行動實在過於迅速,她完全找不到任何的機會喝停血時。500Please respect copyright.PENANAJJ09QtMKFf
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「......」500Please respect copyright.PENANAkTLFleWRuy
她打開演講廳的門口,四周張望,只見血時往著月亮咖啡店的方向奔跑起來。500Please respect copyright.PENANAxxWJ6tmKKh
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「你...沒吃早餐嗎?」500Please respect copyright.PENANA2PCLSEKBuC