直接抗人球蛋白试验、不规则抗体筛查对新生儿溶血病的诊断价值研究  

Diagnostic value of direct anti-globulin test and irregular antibody screening for hemolytic disease of the newborn

作　　者：张玉芹[1] 李岩[1] 张文哲 刘利华[2] Zhang Yu-qin;Li Yan;Zhang Wen-zhe;Liu Li-hua(Blood Transfusion Department,Affiliated Hospital of Jining Medical University,Jining 272000,China;Clinical Laboratory,Affiliated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院附属医院输血科,济宁272000 [2]济宁医学院附属医院检验科,济宁272000

出　　处：《湖南师范大学学报（医学版）》2021年第2期160-163,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探究直接抗人球蛋白试验、不规则抗体筛查对新生儿溶血病(HDN)的诊断价值。方法:选择2018年8月~2020年8月送检的高胆红素症新生儿血液样本216例,进行直接抗人球蛋白试验、游离抗体试验、抗体释放试验及不规则抗体筛查,探究直接抗人球蛋白试验、不规则抗体筛查对新生儿溶血病的诊断价值。结果:在216例送检血样中,确诊为HDN的患儿共99例,其中男性48例,女性51例,两者比较差异无统计学意义;在ABO系统患儿中,HDN发生率为50.27%,Rh系统HDN发生率为17.24%,两者比较差异有统计学意义,Rh系统中发生HDN的1例为抗-E溶血,4例为抗-D溶血;在187例ABO系统患儿中,A型发生HDN的概率为62.20%,B型为40.95%,两者比较差异有统计学意义;99例诊断为HDN患儿中,单独抗体释放试验为阳性患儿2例(2.02%),直接抗人球蛋白试验+抗体释放试验阳性0例,游离抗体试验+抗体释放试验阳性55例(55.56%),三项试验均为阳性患儿42例(42.42%);抗体效价=64、抗体效价=128抗体效价=256患儿的HDN发生率均高于抗体效价<64患儿的HDN发生率,差异有统计学意义。结论:早期进行直接抗人球蛋白试验、游离抗体试验、抗体释放试验及不规则抗体筛查,对早期确诊HDN及防治疗具有较好价值。Objective To explore the diagnostic value of direct anti-globulin test and irregular antibody screening for hemolytic disease of the newborn(HDN).Methods The blood samples from 216 hyperbilirubinemia neonates from August 2018 to August 2020 were enrolled for direct anti-globulin test,free antibody test,antibody release test and irregular antibody screening.The diagnostic value of direct anti-globulin test and irregular antibody screening for HDN was explored.Results Among the 216 blood samples,there were 99 cases confirmed with HDN,including 48 males and 51 females.There was no significant difference between the two.The incidence rates of HDN in children with ABO system and Rh system were 50.27% and 17.24%.In Rh system,there was 1 case with anti-E hemolysis and 4 cases with anti-D hemolysis.Among the 187 children with ABO system,the incidence rates of type A and type B HDN were 62.20% and 40.95%.Among the 99 neonates with HDN,antibody release test,direct anti-globulin test combined with antibody release test,and free antibody test combined with antibody release test showed that there were 2 positive cases(2.02%),0 positive case and 55 positive cases(55.56%),respectively.There were 42 positive cases(42.42%)in the three tests.The incidence of HDN in children with antibody titer equaling to 64,128 and 256 was higher than that lower than 64.Conclusion Early direct anti-globulin test,free antibody test,antibody release test and irregular antibody screening are of good value for early confirming and prevention of HDN.

关 键 词：新生儿溶血病 直接抗人球蛋白试验 不规则抗体筛查 游离抗体试验 抗体释放试验 

分 类 号：R722.18[医药卫生—儿科]