新生儿ABO溶血病直接抗球蛋白试验阳性与阴性患儿血红蛋白、网织红细胞百分比、总胆红素水平及意义分析  

Analysis of hemoglobin,reticulocyte percentage and total bilirubin levels and significance in children with positive and negative direct antiglobulin tests for neonatal ABO hemolytic disease

作　　者：吴浩[1] 王凯[2] 朱向宝 Wu Hao;Wang Kai;Zhu Xiangbao(Department of Blood Transfusion,Suzhou Hospital Affiliated to Anhui Medical University,Suzhou 234000,China;Department of Laboratory,Suzhou Hospital Affiliated to Anhui Medical University,Suzhou 234000,China;Department of Neonatology,Suzhou Hospital Affiliated to Anhui Medical Department,Suzhou 234000,China)

机构地区：[1]安徽医科大学附属宿州医院输血科,宿州234000 [2]安徽医科大学附属宿州医院检验科,宿州234000 [3]安徽医科大学附属宿州医院新生儿科,宿州234000

出　　处：《中国医师进修杂志》2024年第4期332-336,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析新生儿ABO溶血病(ABO-HDN)直接抗球蛋白试验(直抗试验)阳性与阴性患儿血红蛋白(Hb)、网织红细胞百分比(Ret%)、总胆红素(TBil)水平及意义。方法回顾性选取2020年1月至2022年6月安徽医科大学附属宿州医院收治的106例ABO-HDN患儿为研究对象,根据直抗试验结果分为阳性组(52例)与阴性组(54例),比较两组和不同直抗试验凝集强度患儿Hb、Ret%、TBil水平,应用Pearson检验分析Hb、Ret%、TBil水平与发病日龄、黄疸出现时间、直抗试验凝集强度的相关性,采用受试者工作特征(ROC)曲线分析Hb、Ret%、TBil水平诊断ABO-HDN的价值。结果阳性组与阴性组产妇年龄、新生儿性别、出生体质量、出生身高、出生孕周、母亲产史、分娩方式、患儿血型比较差异无统计学意义(P>0.05)。阳性组Hb低于阴性组[(104.66±25.34)g/L比(125.81±17.56)g/L],Ret%、TBil高于阴性组[(5.16±2.21)%比(4.20±1.34)%、(245.86±71.35)μmol/L比(218.93±66.74)μmol/L],发病日龄、黄疸出现时间早于阴性组[(2.01±0.45)d比(2.97±0.53)d、(3.13±1.25)d比(4.08±1.19)d],差异均有统计学意义(P<0.05)。Pearson检验结果表明,Hb水平与发病日龄、黄疸出现时间呈正相关(r=0.840、0.822,P<0.01),Ret%、TBil水平与发病日龄(r=-0.827、-0.820,P<0.01)、黄疸出现时间(r=-0.773、-0.732,P<0.01)呈负相关。ROC曲线分析结果表明,Hb+Ret%+TBil诊断ABO-HDN的曲线下面积大于任一指标(P<0.05)。随着直抗试验凝集强度增加,Hb水平逐渐降低,Ret%、TBil水平逐渐升高(P<0.05);Hb与直抗试验凝集强度呈负相关(r=-0.743,P<0.01),Ret%、TBil与直抗试验凝集强度呈正相关(r=0.773、0.728,P<0.01)。结论ABO-HDN直抗试验阳性、阴性患儿Hb、Ret%、TBil水平存在明显差异,且Hb、Ret%、TBil水平与发病日龄、黄疸出现时间、直抗试验凝集强度密切相关,联合检测对ABO-HDN诊断具有较高价值。Objective To analyze the hemoglobin(Hb),reticulocyte percentage(Ret%)and total bilirubin(TBil)levels and their significance in children with positive and negative direct antiglobulin test in neonatal ABO hemolytic disease(ABO-HDN).Methods Retrospectively selected 106 children with ABO-HDN admitted to Suzhou Hospital Affiliated to Anhui Medical University from January 2020 to June 2022,and they were divided into positive group and negative group according to the results of the direct antiglobulin test,Hb,Ret%,TBil levels between the two groups and different agglutination intensity were compared,the relationship of Hb,Ret%,TBil levels and the age of onset,the time of jaundice appearance and the degree of agglutination intensity were analyzed by Pearson correlation,the correlation between Hb,Ret%,TBil levels and the diagnosis of ABO-HDN were analyzed by the operating characteristic(ROC)curve.Results The maternal age,neonatal sex,birth weight,birth height,week of gestation,maternal history,mode of delivery and blood type of the children between the two groups had no statistical differences(P>0.05).The Hb level in the positive group was lower than that in the negative group,Ret%and TBil level were higher than those in the negative group,and the age of onset and time to appearance of jaundice were earlier than those in the negative group:(104.66±25.34)g/L vs.(125.81±17.56)g/L,(5.16±2.21)%vs.(4.20±1.34)%,(245.86±71.35)μmol/L vs.(218.93±66.74)μmol/L,(2.01±0.45)d vs.(2.97±0.53)d,(3.13±1.25)d vs.(4.08±1.19)d,there were statistical differences(P<0.05).The results of Pearson correlation showed that Hb was positively correlated with the age of onset and time to appearance of jaundice(r=0.840,0.822,P<0.01),Ret%and TBil were negatively correlated with age of onset(r=-0.827,-0.820,P<0.01)and time to appearance of jaundice(r=-0.773,-0.732,P<0.01).The results of ROC curve showed that the area under the curve of Hb+Ret%+TBil for the diagnosis of ABO-HDN was greater than other index(P<0.05).Compared the levels of Hb,Ret%

关 键 词：贫血 新生儿 血红蛋白 直接抗球蛋白试验 网织红细胞百分比 总胆红素 

分 类 号：R722.18[医药卫生—儿科]