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目的通过对高胆红素血症新生儿进行新生儿溶血症的血清学检测,评价血清学试验在新生儿溶血病诊断中的价值,分析其与血清胆红素浓度的相关性。方法用微柱凝胶法检测卡进行溶血三项试验,同时进行血清胆红素的检测,并对结果进行统计学分析。结果 265例母婴血型不合病例中,抗体释放试验阳性率为54.3%,游离抗体试验阳性率为49.1%,直接抗人球蛋白试验阳性率为17.0%。高胆红素血症占47.2%(125/265),血清学试验阳性组高胆红素血症的发生率显著高于试验阴性组(χ~2=32.36,P<0.01)和对照组(χ2=54.58,P<0.01)。直接抗人球蛋白试验、游离抗体试验以及抗体释放试验阳性率与血清胆红素浓度未见明显相关性(P>0.05),游离抗体试验与抗体释放试验有很强的相关性(r=0.897,P<0.01)。结论溶血三项血清学试验中直接抗人球蛋白试验诊断的特异度最高,抗体释放试验诊断的敏感度最高。血清学试验阳性率与血清胆红素浓度无明显相关性,游离抗体试验与抗体释放试验有很强的相关性。
Objective To evaluate the value of serological tests in the diagnosis of hemolytic disease in newborns by serological detection of neonatal hemolytic disease in neonates with hyperbilirubinemia and analyze the correlation with serum bilirubin concentration. Methods Three micro-column gel test card hemolysis test, at the same time the detection of serum bilirubin, and the results were statistically analyzed. Results Among the 265 maternal and child incompatibility cases, the positive rate of antibody release test was 54.3%. The positive rate of free antibody test was 49.1%. The positive rate of direct anti-human globulin test was 17.0%. The incidence of hyperbilirubinemia in positive serological test group was significantly higher than that in negative test group (χ ~ 2 = 32.36, P <0.01) and control group (47.2% χ2 = 54.58, P <0.01). Direct anti-human globulin test, free antibody test and antibody release test positive rate and serum bilirubin concentration no significant correlation (P> 0.05), free antibody test and antibody release test has a strong correlation (r = 0.897 , P <0.01). Conclusion The specificity of direct anti-human globulin test in hemolytic three serological tests is the highest, and the sensitivity of antibody test is the highest. There was no significant correlation between the positive rate of serological test and the serum bilirubin concentration. There was a strong correlation between free antibody test and antibody release test.