血型血清学检测技术对新生儿溶血病的诊断价值

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目的:探讨血清学检测技术对新生儿溶血病(HDFN)的诊断价值.方法:收集2016-07-11-2017-02-10陕西省人民医院产科及新生儿科患有高胆红素血症的新生儿1 000例患儿样本,对其进行血型鉴定、不规则抗体筛查检测、直接抗人球蛋白试验、游离抗体试验以及抗体释放试验检测.结果:①母婴血型不合者615例,以病历出院诊断确诊HDFN患儿281例(45.7%).②615例母婴血型不合患者中,ABO、Rh系统HDFN发生率分别为50.57%(267/528)、16.09%(14/87),比较差异有统计学意义(P<0.05).③ABO血型系统母婴血型不合者528例,A、B型血发病率分别为62.2%及41.4%,差异有统计学意义(P<0.05).④在确诊的281例HDFN患者中,血清学试验3项(直接抗人球蛋白试验、抗体释放试验阳性、游离抗体试验)均为阳性结果占1.8%;直接抗人球蛋白试验阴性而其余为试验阳性结果占3.6%;游离抗体实验阴性而其余为试验阳性结果占7.1%;单独抗体释放试验阳性结果占87.5%.⑤528例O型母亲血清中Ig-G抗A(B)效价≥64的有216例,确诊为HDFN为174例(80.6%);Ig-G抗A(B)<64的有312例,确诊为HDFN的有93例(29.8%),差异有统计学意义(P<0.05).结论:血清学检测技术对HDFN诊断起到一定辅助作用.“,”Objective:To investigate the diagnostic value of serological detection and detection technique for hemolytic disease of the newborn(HDFN). Method: A total of 1 000 newborns with hyperbilirubinemia in the department of obstetrics and neonatology of Shaanxi Provincial Peoples Hospital were collected from 2016-07-11-2017-02-10. Blood group identification and screening for irregular antibodies were performed,direct anti-human globulin test,free antibody test and antibody release test. Result:①There were 615 cases with maternal and neonatal blood group incompatibility, and 281 cases (45.7%) were diagnosed with HDFN by medical records. The incidence of HDFN in ABO and Rh system was 50.57 % (267/528)and 16.09%(14/87).② The 615 cases of maternal and neonatal blood type incompatibility respectively. The difference was statistically significant(P<0.05).③The 528 cases of maternal and neonatal blood type mismatch in ABO blood type system,the incidence rate of type A and type B blood were 62.2% and 41.4% respectively. The difference was statistically significant(P<0.05).④Of the 281 HDFN patients diagnosed, 3 were serological tests(direct antiglobulin test, positive antibody release test,and free antibody test) with positive results of 1.8%; direct antiglobulin test was negative and the rest were The positive result of the test accounted for 3.6 %; the free antibody test was negative and the remaining test positive result was 7.1 %;the positive result of the single antibody release test accounted for 87.5%. There were 216 Ig-G anti-A(B) titers in the serum.⑤The 528 type O mothers,of which 174 (80.6%) were diagnosed with HDFN,and 312 were Ig-G anti A(B)<64. There were 93 cases(29.8%)diagnosed with HDFN,and the difference was statistically significant (P<0.05). Conclusion;Serological detection technology can play an important role in the diagnosis of HDFN.
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