Ret、COHb与抗体效价滴度联合检测对新生儿溶血症的诊断价值  

Combined detection of Ret, COHb and antibody titer for the diagnosis of neonatal hemolysis

作　　者：桑希智 SANG Xizhi(Heze Maternal and Child Health Family Planning Service Center,HeZe 274000,Shandong)

机构地区：[1]菏泽市妇幼保健计划生育服务中心,山东菏泽274000

出　　处：《菏泽医学专科学校学报》2021年第3期17-19,共3页Journal of Heze Medical College

摘　　要：目的研究联合网织红细胞参数(Ret)、碳氧血红蛋白(COHb)以及抗体效价三项指标对新生儿溶血症诊断的意义和价值。方法选取我院收治的62例溶血性黄疸新生儿标记为观察组;选择同一时期入院治疗的非溶血性病理黄疸患儿62例为对照组;再选取62例体检健康的新生儿为正常对照组。分别在新生儿1周内检测其Ret、COHb以及抗体效价滴度,总结孕妇的血清抗体效价滴度与发生新生儿溶血病间的联系,建立Ret、COHb以及抗体滴度对新生儿溶血病进行诊断的受试特征曲线(ROC曲线),同时计算曲线下的面积,记录最佳截断值,并分析联合检测的特异度以及敏感度。结果观察组患者的Ret、COHb水平相较于对照组、正常对照组较高,Hb显著较低,三组比较,P<0.05;新生儿溶血病的发生概率与抗体效价滴度成正比例相关,与Pearson相关性检验结果一致,二者显著相关;COHb、Ret以及抗体效价滴度的AUC分别为96.5%、84.3%和78.2%,对比三项指标的AUC,差异具有统计学意义(P<0.05),三项指标同时满足条件判断为诊断阳性的敏感度降至为53.5%,特异度升高至98.7%。结论COHb为诊断新生儿溶血症的重要参考指标,同时联合检查Ret以及抗体效价滴度,对新生儿溶血病早期诊断和筛查具有重要意义。Objective To explore the significance and value of reticulocyte parameters(Ret),carboxyhemoglobin(COHb)and antibody titer in the diagnosis of neonatal hemolysis.Methods 62 neonates with hemolytic jaundice admitted to our hospital were selected as the observation group,62 neonates with non-hemolytic pathological jaundice admitted to the hospital during the same period were selected as the control group and 62 healthy neonates were selected as the normal control group.Ret,COHb and antibody titer were measured within 1 week of newborn.The relationship between serum anti body titer in pregnant women and the occurence of neonatal hemolytic disease was concluded.The receiver operating char acteristic curve(ROC curve)for the disease diagnosis was established,simultaneously the area under the curve was calculat ed,the optimal cutoff value was recorded,and the specificity and sensitivity of the joint test were analyzed.Results The levels of Ret and COHb in the observation group were higher than those in the control group and normal control group,and the Hb was significantly lower(P<0.05).The incidence of neonatal hemolytic disease was directly proportional to the anti body titer.The results weere consistent with the Pearson correlation test,and the two were significantly correlated.The AUC of the COBb,Ret and antibody titer were 96.5%,84.3%and 78.2%respectively,the difference was significant(P<0.05).The sensitivity reduced to 53.5%,and the specificity increased to 98.7%.Conclusion COHb is an important refer ence for the diagnosis of hemolytic disease in newborns.The combination of COHb,Ret and antibody titer has important ref erence for early diagnosis and screening of hemolytic disease in newborns.

关 键 词：网织红细胞 碳氧血红蛋白 溶血症 诊断 

分 类 号：R722.18[医药卫生—儿科]