141例母婴血型不合患儿新生儿溶血病检测结果分析  

Analysis of hemolysis tests results of 141 cases with maternal and infant blood group incompatibility

作　　者：韩婷 唐代玉 HAN Ting;TANG Daiyu(Department of Blood Transfusion of the Third People's Hospital of Yunnan Province,Kunming,650011,China)

机构地区：[1]云南省第三人民医院输血科,昆明650011

出　　处：《临床血液学杂志》2023年第6期402-405,共4页Journal of Clinical Hematology

摘　　要：目的:探讨分析母婴血型不合患儿新生儿溶血病(hemolytic disease of newborn,HDN)检测结果及其与患儿间接胆红素(indirect bilirubin,IBIL)之间的关系。方法:选取2020年1月至2021年1月云南省第三人民医院收治的其母亲血型为O型RhD阳性的新生儿血液标本行血型鉴定,并用微柱凝胶试验技术做直接抗人球蛋白试验(direct anti human globulin test,DAT)、红细胞抗体放散试验(放散试验)、血清游离抗体试验(游离试验),根据试验结果判定患儿是否发生ABO溶血,并监测患儿IBIL变化。结果:选取的141例标本中,HDN检测结果阳性101例,可疑阳性2例,阴性38例,HDN阳性患儿IBIL明显高于阴性患儿,差异有统计学意义(P<0.05)。A型患儿77例,HDN阳性62例,阳性率80.52%;B型患儿62例,HDN阳性39例,阳性率62.90%。A型患儿HDN阳性率明显高于B型患儿,差异有统计学意义(P<0.05)。日龄<1 d患儿33例,阳性率51.52%;日龄1~3 d患儿78例,阳性率88.46%;日龄4~6 d患儿16例,阳性率68.75%;日龄≥7 d患儿14例,阳性率28.57%;可见行HDN检测时间越晚的患儿,IBIL越高,而患儿1~3 d时HDN阳性检测率最高,差异有统计学意义(P<0.05)。在HDN阳性患儿中有93例进行了静脉注射丙种球蛋白治疗,比较丙种球蛋白治疗前后的IBIL,发现治疗后患儿IBIL(120.988±31.104)μmol/L明显较治疗前(190.055±63.687)μmol/L低,差异有统计学意义(P<0.05)。结论:A型患儿比B型患儿更易发生新生儿ABO溶血病。采血时间越早HDN检出率越高,采血时间越晚患儿IBIL越高,应尽早行HDN检测,并及时进行丙种球蛋白治疗。Objective To explore and analyze the results of neonatal hemolytic disease(HDN)and its relationship with the blood indirect bilirubin(IBIL)in children with maternal and infant blood group incompatibility.Methods Blood samples of newborns with O-RHD positive mothers admitted to the Third People's Hospital of Yunnan Province from January 2020 to January 2021 were selected for blood group identification.Direct anti-human globulin test(DAT),erythrocyte antibody release test(release test)and serum free antibody test(free test)were performed by microcolumn gel test.ABO hemolysis was determined according to the test results,and the changes in blood IBIL were monitored.Results Among the 141 samples,101 were positive,2 were suspicious positive,and 38 were negative.The blood IBIL value of the children with positive HDN was significantly higher than that of the children with negative HDN,with statistical significance(P<0.05).A total of 77 patients with type A had HDN positive in 62 cases,with a positive rate of 80.52%.A total of 62 patients with type B had HDN positive in 39 cases,with a positive rate of 62.90%.The positive rate of HDN in type A children was significantly higher than that in type B children,and the difference was statistically significant(P<0.05).33 cases were less than 1 day old,with a positive rate of 51.52%.78 cases were 1-3 days old,with a positive rate of 88.46%.16 cases were 4-6 days old,with a positive rate of 68.75%.14 cases were older than 7 days,with a positive rate of 28.57%.It could be seen that the later the time of HDN detection,the higher the blood IBIL value,and the HDN positive detection rate was the highest in children 1 to 3 days,the difference was statistically significant(P<0.05).Among the children with HDN positive,93 patients received intravenous injection of gamma globulin.By comparing the blood IBIL before and after treatment,it was found that the blood IBIL of the children after treatment(120.988±31.104)μmol/L was significantly lower than that before treatment(190.055±63.687)μm

关 键 词：新生儿溶血病 高胆红素血症 抗人球蛋白试验 抗体放散试验 游离抗体试验 

分 类 号：R722.18[医药卫生—儿科]