母婴血型不合导致的新生儿溶血病实验室分析  

Analysis of laboratory result of mother-to-child ABO hemolytic disease of the newborn

作　　者：赵玉河[1] 张樱子[1] 高冀辉[1] 张晨光[2] 

机构地区：[1]新乡医学院第一附属医院输血科,河南新乡453100 [2]新乡医学院检验系

出　　处：《临床血液学杂志（输血与检验）》2014年第3期445-447,共3页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

基　　金：河南省科技厅科研项目(No:132102310163)

摘　　要：目的:对母婴血型不合导致新生儿发生溶血的实验室数据进行分析,为新生儿溶血病(HDN)的诊断提供早期数据。方法:共纳入97例HDN患者,清晨空腹抽取160例新生儿脐血及其母亲肘静脉血液,进行ABO、Rh血型鉴定及新生儿脐血直接抗人球蛋白试验、游离抗体试验、抗体释放试验。结果:160份临床疑为HDN的标本中,患儿全部为Rh阳性,1例母亲为Rh阴性,其中A型者60例,B型80例,O型18例。血型血清学检测证实的血型抗原不合引起的HDN例数为97例,总阳性率为60.6%,其中ABO-HDN 96例,Rh-HDN 1例。在被证实为ABO-HDN的96例患儿中,A型41例,占25.6%,B型55例,占34.4%。在18例O型血患儿中,直接抗人球蛋白试验和游离抗体试验检测筛查均为阴性。1例母亲为Rh阴性患儿ABO血型与其母亲同为A型,直接抗人球蛋白实验结果阳性。结论:血型抗原不合引起的HDN中,ABO-HDN明显比Rh-HDN多见,其中又以母亲为O型的B型新生儿多见。抗体释放试验比直接抗人球蛋白试验及游离抗体试验诊断HDN的准确率高。为临床上早期诊断HDN提供重要的依据,对防止胆红素脑病的发生具有重要意义。Objective：To analyze the laboratory data of hemolytic disease of the newborn （HDN） caused by maternal-fetal blood group incompatibility, and provide early direct data for the diagnosis of HDN. Method：A total of 97 cases of HDN patients were entered. ABO,Rh blood group identification and umbilical blood direct antiglobulin test, free antibody test, antibody release test from 160 cases of neonatal cord blood and maternal cubital vein blood were done. Result：Am0ng the 160 suspected HDN specimens, patients were all Rh positive, 1 case for Rh negative mothers, including 60 cases of type A, 80 cases of B and 18 cases of O. There were 97 cases of blood group antigen induced HDN confirmed by blood group serological testing, and the total positive rate was 60.6%, including 96 cases of ABO-HDN and 1 case of Rh-HDN. In the confirmed 96 ABO-HDN patients, 41 cases were type A, accounting for 25.6%, and 55 cases were type B, accounting for 34.4%. In 18 patients with blood type O, the results of direct antiglobulin test and free antibody test were negative. ABO blood group of 1 case with negative Rh mother was type A, the same as he mother, with positive results of direct Coombs test. Conclusion： During HDN induced by blood group antigen, ABO-HDN is more common than Rh-HDN, and type B neonatal with O type mother is common. The accuracy of antibody release test would be higher than＇ that of direct antiglobulin test and free antibody test for the diagnosis of HDN, which could provide important basis for clinical early diagnosis of HDN and be important significance in the prevention of bilirubin eneephalopathy.

关 键 词：母婴血型不合 新生儿溶血病 实验室分析 

分 类 号：R722.18[医药卫生—儿科]