流式细胞术检测网织红细胞参数对新生儿溶血病的诊断价值  

The Diagnosis Value of Reticulocyte Parameter by Flow Cytometry in Neonatal Hemolytic Disease

作　　者：徐芬[1] 罗俊[1] 袁康凯[1] 李月凤 卢光进[1] 

机构地区：[1]广东省深圳市宝安区妇幼保健院,广东深圳518102 [2]广东省深圳市罗湖区妇幼保健院,广东深圳518001

出　　处：《儿科药学杂志》2018年第3期3-5,共3页Journal of Pediatric Pharmacy

基　　金：深圳市宝安区科技创新项目;编号2010597

摘　　要：目的:采用流式细胞术,探讨网织红细胞(Ret)参数在新生儿ABO血型不合溶血病诊断中的临床价值。方法:选择2016年8月至2017年2月在深圳市宝安区妇幼保健院新生儿科确诊的新生儿ABO血型不合溶血病患儿100例为溶血病组,另选择生后7 d内溶血病放散试验阴性的足月黄疸患儿100例为非溶血病组,应用血液分析仪检测两组患儿的Ret百分率(Ret%)、未成熟Ret比率(IRF)、Ret成熟指数(RMI)及低、中、高荧光Ret百分率(LFR%、MFR%、HFR%)。应用ROC分析Ret%和IRF对新生儿溶血病的诊断价值。结果:两组患儿Ret%、IRF、LFR%、MFR%、HFR%、RMI比较差异均有统计学意义(P均<0.01),随日龄增加,Ret%、IRF逐渐降低,LFR%逐渐升高。Ret%和IRF诊断新生儿溶血病的受试者工作特征曲线下面积(ROC-AUC)分别为0.80和0.69,最佳截断值分别为4.25和28.95,灵敏度和特异度分别为71%、80%和80%、57%。结论:流式细胞术检测Ret参数有助于判断红细胞的活动度,了解Ret在新生儿溶血病自然病程中的变化规律,对新生儿溶血病的诊断及鉴别诊断具有一定的实用价值。Objective： To analyze the clinical value of reticulocyte parameter by flow cytometry in the diagnosis of ABO hemolytic disease of the newborn. Methods： One hundred cases of children with the definite diagnosis of ABO hemolytic disease in Shenzhen Bao＇an District Maternal and Child Health Care Hospital from Aug. 2016 to Feb. 2017 were selected as hemolytic disease group,and one hundred cases of jaundice children with negative results of elution test were selected as non-hemolytic disease group. The reticulocyte percentage（ Ret%）,immature reticulocyte factor（ IRF）,reticulocyte percentage maturity index（ RMI） and low,median,high fluorescence ratio of reticulocytes（ LFR%,MFR%,HFR%） were determined by hematology analyzer. The diagnosis value of Ret% and IRF for ABO hemolytic disease of the newborn was analyzed by ROC. Results： Compared with non-hemolytic disease group,the differences of Ret%,IRF,LFR%,MFR%,HFR% and RMI in hemolytic disease group were statistically significant（ P〈0. 01）. With the older of neonates,Ret% and IRF decreased gradually in both groups,but LFR% increased gradually. The areas under curves of Ret% and IRF for the diagnosis of hemolytic disease by Ret% and IRF were 0. 80 and 0. 69 respectively,the optimal cut-off values were4. 25 and 28. 95 respectively,besides,the sensitivity and specificity were 71%,80% and 80%,57% respectively. Conclusion： The detection of reticulocyte parameters is useful in determining the activity of red blood cells. To understand the regularity of Ret in the natural course of the hemolytic disease of newborn have a certain practical value for the diagnosis and differential diagnosis of this kind of disease.

关 键 词：网织红细胞 新生儿 溶血病 流式细胞术 

分 类 号：R722.1[医药卫生—儿科]