血清非结合胆红素联合溶血三项在新生儿ABO溶血性高胆红素血症中的检测意义  

Significance of serum unconjugated bilirubin combined with three hemolysis tests in detecting neonatal ABO hemolytic hyperbilirubinemia

作　　者：徐亚敏 陈玲 吴丽 XU Yamin;CHEN Ling;WU Li(Department of Blood Transfusion,Hefei Binhu Hospital,Hefei,Anhui,230601,China)

机构地区：[1]合肥市滨湖医院输血科,安徽合肥230601

出　　处：《当代医学》2023年第7期21-24,共4页Contemporary Medicine

摘　　要：目的探究血清非结合胆红素联合溶血三项在新生儿ABO溶血性高胆红素血症中的检测意义。方法回顾性分析2019年11月至2020年8月本院收治的93例高胆红素血症患儿的临床资料,所有患儿均进行血清非结合胆红素和溶血三项检查,根据溶血三项试验结果将患儿分为4组,1组为直接抗人球蛋白试验阳性、游离抗体试验阳性、抗体释放试验阳性(n=13),2组为直接抗人球蛋白试验阴性、游离抗体试验阳性、抗体释放试验阳性(n=32),3组为直接抗人球蛋白试验阴性、游离抗体试验阴性、抗体释放试验阳性(n=19),4组为直接抗人球蛋白试验阴性、游离抗体试验阴性、抗体释放试验阴性(n=29);另选取同期15名非结合胆红素水平正常的健康儿童作为对照组,分析高胆红素血症患儿ABO溶血三项试验阳性率,比较高胆红素血症患儿与对照组血清非结合胆红素水平。将患儿按母婴血型的不同分为O/O组(n=15)、O/A组(n=38)、O/B组(n=40),比较不同母婴血型患儿溶血三项试验阳性率。根据患儿总胆红素水平将患儿分为A组(n=48,重度高胆红素血症)、B组(n=33,极重度高胆红素血症)、C组(n=12,危险性高胆红素血症),分析A组、B组、C组ABO溶血症(ABO-HDN)、血清非结合胆红素差异。结果93例患儿中,直抗阳性率(13.98%)明显低于游离阳性率(48.39%)、释放阳性率(68.82%),差异有统计学意义(P<0.05);O/A组、O/B组、O/O组直抗阳性率比较差异无统计学意义,三组游离、释放阳性率差异有统计学意义(P<0.05),其中O/A组、O/B组溶血三项试验差异比较无统计学意义;5组间血清非结合胆红素水平比较差异有统计学意义(P<0.05),1、2、3、4组明显高于对照组,且1、2、3组明显高于4组(P<0.05),1、2、3组比较差异无统计学意义;A、B、C 3组ABO-HDN阳性检出率、血清非结合胆红素比较差异有统计学意义(P<0.05),C组ABO-HDN阳性检出率明显低于A、B组(P<0.05),A、Objective To investigate the significance of serum unconjugated bilirubin combined with three hemolysis tests in detectingneonatal ABO hemolytic hyperbilirubinemia.Methods Clinical data of 93 children with hyperbilirubinemia admitted to our hospital from November 2019 to August 2020 were retrospectively analyzed.All the children underwent serum unbound bilirubin and hemolysis tests,and were divided into four groups according to the results of the three hemolysis tests,group 1 was positive for direct anti-human globulin test,positive for free antibody test and positive for antibody release test(n=13),group 2 was negative for direct anti-human globulin test,positive for free antibody test and positive for antibody release test(n=32),group 3 was negative for direct anti-human globulin test,negative for free antibody test and positive for antibody release test(n=19),group 4 were negative for direct anti-human globulin test,negative for free antibody test and negative for antibody release test(n=29).At the same time,15 healthy children with normal unbound bilirubin levels were selected as the control group during the same period,the positive rates of ABO hemolysis tests in hyperbilirubinemia children were analyzed,and serum unbound bilirubin levels in hyperbilirubinemia children and control group were compared.The children were divided into O/O group(n=15),O/A group(n=38)and O/B group(n=40)according to the difference of maternal and infant blood types,the positive rates of three hemolysis tests in children with different blood types were compared.According to the total bilirubin level,the children were divided into group A(n=48,severe hyperbilirubinemia),group B(n=33,extremely severe hyperbilirubinemia)and group C(n=12,dangerous hyperbilirubinemia),the ABO-hemolytic disease of the newborn(ABO-HDN)and serum unbound bilirubin in group A,group B and group C were analyzed.Results Of the 93 neonates,the positive rate of direct anti-human globulin test was 13.98%,which was significantly lower than that of free antibody test

关 键 词：新生儿 ABO溶血症 高胆红素血症 非结合胆红素 溶血三项 

分 类 号：R722.18[医药卫生—儿科]