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目的:通过对ABO、Rh血型不合的新生儿溶血病患儿进行血型血清学诊断,为临床及时治疗提供依据。方法:运用血型血清学技术对海南省人民医院送检的高胆红素血症新生儿血液标本进行直接抗人球蛋白试验、游离抗体试验和抗体释放试验。结果:HDN患儿中,3项试验均为阳性的有55例,占21.2%;直接抗人球蛋白试验阴性、游离抗体试验和抗体释放试验阳性的有119例,占46.0%;直接抗人球蛋白试验、游离抗体试验为阴性而抗体释放试验阳性的有85例,占32.8%;释放试验均阳性(阳性率100%),174例游离抗体试验阳性(阳性率67.2%),55例直接抗人球蛋白试验阳性(阳性率21.2%)。259例HDN患儿中,共有81例患儿换血,总换血率31.3%。B型患儿换血率与A型患儿比较差异有统计学意义(x2=7.48P<0.05)。结论:直接抗人球蛋白试验的强弱是区别ABO和Rh溶血病的重要标志;抗体释放试验是判定新生儿溶血病的最有力证据;换血疗法是新生儿溶血病的最有效的方法,可减少胆红素脑病的发生。
OBJECTIVE: To provide a basis for clinical treatment by analyzing blood group serology in neonates with hemolytic disease of non-ABO and Rh blood group. Methods: The blood samples of neonates with hyperbilirubinemia submitted by Hainan Provincial People’s Hospital were tested for direct anti-human globulin test, free antibody test and antibody release test by using blood group serological technique. Results: In HDN children, 55 cases (21.2%) were positive in all three tests. The direct anti-human globulin test was negative. There were 119 cases (46.0%) with free antibody test and antibody release test. Globulin test, free antibody test was negative and antibody release test was positive in 85 cases, accounting for 32.8%; release test was positive (positive rate 100%), 174 cases of free antibody test was positive (positive rate 67.2%), 55 cases of direct Anti-human globulin test was positive (positive rate of 21.2%). In 259 cases of HDN children, a total of 81 patients with transfusion, the total exchange rate of 31.3%. The rate of blood exchange in children with type B was significantly different from that in children with type A (x2 = 7.48P <0.05). CONCLUSION: The strength of direct anti-human globulin test is an important marker to distinguish ABO and Rh hemolytic disease. Antibody releasing test is the most powerful evidence to determine neonatal hemolytic disease. Transfusion therapy is the most effective method for neonatal hemolytic disease. Reduce the occurrence of bilirubin encephalopathy.