高胆血症新生儿溶血症血清学检测结果及相关因素的分析  

Analysis of serological test results of neonatal hemolytic disease and related factors in neonatal hyperbilirubinemia

作　　者：陈陆飞[1] 吴坤海[1] 刘琛[1] 林鸿星[1] 

机构地区：[1]福建省妇幼保健院输血科,福州350001

出　　处：《国际检验医学杂志》2014年第23期3173-3175,共3页International Journal of Laboratory Medicine

摘　　要：目的分析高胆红素血症患儿新生儿溶血病(hemolytic disease of newborn,HDN)血清学检测结果并探讨与其相关因素之间的关系。方法对796例高胆红素血症患儿的血样进行新生儿溶血三项试验,并分析HDN阳性率与血型、送检日龄、血红蛋白水平及血清总胆红素值等因素的关系。结果 796例高胆红素血症患儿中HDN患儿184例(23.12%),其中ABOHDN 176例,Rh-HDN 8例。796例患儿血样检测结果中游离试验阳性180例(22.61%),释放试验阳性184例(23.12%),直抗试验阳性140例(17.59%)。B型血患儿HDN阳性率高于A型血患儿,差异有统计学意义(χ2=10.30,P<0.05)。HDN阳性率与送检日龄密切相关,且日龄越大阳性检出率越低,差异有统计学意义(P<0.05)。184例HDN阳性患儿血红蛋白水平及血清总胆红素值与HDN患儿差异有统计学意义(P<0.05)。结论高胆红素血症患儿HDN阳性率较高,应尽早进行溶血三项试验,并可结合血红蛋白水平及血清总胆红素值来提高HDN检出率。Objective To analyze the serological detection results of hemolytic disease of newborns（HDN）in neonatal hyperbil-irubinemia and to explore the relationship between serological results and related factors.Methods The neonatal hemolytic three i-tems test were performed on blood specimens of 796 cases of neonatal hyperbilirubinemia.The relationship between the positive rate of HDN with the related factors such as blood type,specimens collecting time,hemoglobin level and serum total bilirubin value was analyzed.Results Among 796 cases of hyperbilirubinemia,184 cases were HDN（23.12%）,in which 796 cases were ABO-HDN and 8 cases were Rh-HDN.The direct free antibody test,antibody release test and direct antiglobulin test were positive in 180 cases （22.61%）,184 cases（23.12%）and 140 cases（17.59%）respectively.The HDN positive rate of the newborns with B blood type was higher than that of the newborns with A blood type,the difference between them had statistical significance（χ2 = 10.304,P 〈0.05）.The HDN positive rate was closely related with the specimen collection time,moreover,the greater the day age,the higher the HDN positive rate,the difference showing statistical significance（P 〈0.05）.The hemoglobin level and serum total bilirubin val-ue had statistically significant difference between newborns with HDN and those without HDN（P 〈0.05）.Conclusion The posi-tive rate of HDN is high in newborns with hyperbilirubinemia.The hemolytic three items test should be performed as early as possi-ble.Combining with the hemoglobin level and serum total bilirubin value can increase the HDN detection rate.

关 键 词：高胆红素血症 新生儿溶血症 直接抗人球蛋白试验 游离抗体试验 抗体释放试验 

分 类 号：R722.1[医药卫生—儿科]