溶血三项试验和血清总胆红素联合检测对新生儿溶血病的早期诊治价值  

The early diagnostic and treatment value of combined detection of hemolysis three tests and measurement of serum total bilirubin for hemolytic disease of newborn

作　　者：杨正梅[1] 衡二虎[2] 

机构地区：[1]蚌埠市第一人民医院输血科,安徽省蚌埠233000 [2]蚌埠市第一人民医院检验科,安徽省蚌埠233000

出　　处：《中国基层医药》2014年第10期1460-1462,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的：探讨联合检测溶血三项试验（直接抗人球蛋白试验、游离抗体测定和抗体放散试验）和血清总胆红素对新生儿溶血病（ HDN）的早期诊治价值。方法采用微柱凝胶卡式法检测212例黄疸新生儿静脉血（母亲血型均为O型）溶血三项试验，根据试验阳性率将溶血三项试验阳性的患儿分为下列四组：1组：直抗试验（＋）、游离试验（＋）、释放试验（＋）；2组：直抗试验（＋）、游离试验（-）、释放试验（＋）；3组：直抗试验（-）、游离试验（＋）、释放试验（＋）；4组：直抗试验（-）、游离试验（-）、释放试验（＋）。统计各组构成比，使用全自动生化分析仪测定各组的血清总胆红素水平并比较。结果直接抗人球蛋白试验、游离抗体试验及抗体释放试验阳性率分别为18．4％（39/212）、33．5％（71/212）、39．6％（84/212），游离试验阳性率和抗体释放试验阳性率差异无统计学意义（χ^2＝1．70，P＞0．05），与直抗试验阳性率差异均有统计学意义（χ^2＝23．18，12．58，均P＜0．05）。四组患儿血清总胆红素水平均有显著升高，但组间差异均无统计学意义（F＝1．369，P＞0．05）。结论溶血三项试验和血清总胆红素联合检测作为HDN的早期诊断和分析病情的依据，有助于及早控制新生儿溶血升高，降低并发症和后遗症的出现。Objective To explore the early diagnostic and treatment value of combined detection of direct antiglobulin test ,free antibody and antibody releasing test （ hemolysis three tests ） and measurement of serum total bili-rubin for hemolytic disease of newborn （ HDN） .Methods Hemolysis three tests were carried out with micro column gel technology in 212 blood samples from neonatal jaundice （ derived from the O type mothers ） and positive rate differ-ences in hemolysis three tests were compared .Patients were divided into 4 groups by the antibody results in hemolysis three tests：group 1[direct antiglobulin test （ ＋）,free antibody test （ ＋） and antibody releasing test （ ＋）],group 2[（direct antiglobulin test（＋）,free antibody test（-） and antibody releasing test（＋）],group 3[direct antiglobu-lin test（-）,free antibody test（＋） and antibody releasing test（＋）,and group 4[direct antiglobulin test（ -）,free antibody test （-） and antibody releasing test （＋） ] .Constituent ratio was compared .The total bilirubin in serum from four groups were determined by automatic biochemical analyzer and compared .Results The positive rates of direct antiglobulin test,free antibody test and antibody release test were 18.4%（39/212）,33.5%（71/212） and 39.6%（84/212） respectively.The positive rate had no significant difference between antibody release test and free antibody test（χ2 =1.70,P〉0.05）,but compared with direct antiglobulin test ,the differences were significant （χ^2 =23.18, 12.58,all P〈0.05）.Serum total bilirubin levels in four groups were significantly increased ,but had no significant differences（F=1.369,P〉0.05）.Conclusion Combined detection of serum total bilirubin and serum hemolysis three tests can be used as the early diagnosis and patients condition of HDN ,and contribute to the early control of neo-natal hemolytic increase ,reduce complications and sequelae .

关 键 词：贫血 新生儿 黄疸 新生儿 诊断 实验室技术和方法 

分 类 号：R722.18[医药卫生—儿科]