疑似ABO-HDN患儿的溶血三项检测结果及影响因素分析  

Analysis of hemolysis test results and influencing factors in suspected ABO-HDN children

作　　者：吴理淑 汪文峰 肖峰[1] WU Li-shu;WANG Wen-feng;XIAO Feng(Department of Blood Transfusion,Fuding Hospital,Fuding 355200,Fujian,CHINA)

机构地区：[1]福鼎市医院输血科,福建福鼎355200

出　　处：《海南医学》2024年第14期2042-2046,共5页Hainan Medical Journal

摘　　要：目的检测疑似ABO新生儿溶血病(ABO-HDN)的溶血三项,并分析ABO-HDN的影响因素。方法回顾性分析2022年1~12月福鼎市医院收治的150例疑似ABO-HDN患儿的临床资料,所有患儿均进行溶血三项检测,收集所有患儿的相关资料,并分别采用单因素分析、多因素Logistic回归模型分析ABO-HDN的影响因素。结果150例疑似样本中108例被确诊为ABO-HDN,其中直接抗球蛋白试验阳性27例(25.00%),血清游离抗体检测阳性45例(41.67%),红细胞抗体释放试验阳性108例(100.00%),组合试验中,血清游离抗体试验联合红细胞抗体释放试验的阳性率最高;单因素分析结果显示,新生儿ABO-HDN与母-婴血型、妊娠次数、出生体质量和送检日龄有关(P<0.05);经多因素Logistic回归分析结果显示,母-婴血型(母亲血型为O型)(OR=2.303)、妊娠次数(≥2次)(OR=2.214)、出生体质量(≥3000 g)(OR=2.065)、送检日龄(1~3 d)(OR=2.090)是患儿发生ABO-HDN的危险因素(P<0.05)。结论溶血三项试验是ABO-HDN特异性诊断方法,及早检测有利于提高诊断准确率。母亲妊娠次数超过2次、母亲血型为O型、出生体质量高于3000 g、送检日龄1~3 d是ABO-HDN发生的危险因素。Objective To detect the three items of hemolysis in patients with suspected ABO hemolytic disease of newborn(ABO-HDN)and analyze the influencing factors of ABO-HDN.Methods The clinical data of 150 children with suspected ABO-HDN admitted to Fuding Hospital from January 2022 to December 2022 were retrospectively analyzed.All the children underwent hemolysis tests.The relevant data of all the children were collected,and the influencing factors of ABO-HDN were analyzed by univariate analysis and multivariate Logistic regression model.Results Among the 150 suspected samples,108 were confirmed as ABO-HDN,of which 27(25.00%)were positive for direct antiglobulin test,45(41.67%)were positive for serum free antibody test,and 108(100.00%)were positive for erythrocyte antibody release test;the positive rate of serum free antibody test combined with erythrocyte antibody release test was the highest.Univariate analysis showed that ABO-HDN was related to blood type of mother and infant,number of gestation,birth weight,and age of delivery(P<0.05).Multivariate Logistic regression analysis showed that mothers'blood type of O(OR=2.303),number of pregnancies≥2(OR=2.214),birth weight≥3000 g(OR=2.065),and age of 1-3 d(OR=2.090)were the risk factors for ABO-HDN(P<0.05).Conclusion The three items of hemolysis tests are specific diagnostic methods for ABO-HDN,and early detection is beneficial to improve diagnostic accuracy.The risk factors of ABO-HDN were number of pregnancies≥2,mothers'blood type of O,birth weight≥3000 g,and and age of 1-3 d.

关 键 词：ABO新生儿溶血病 血型 新生儿 直接抗人球蛋白试验 游离抗体试验 抗体放散试验 影响因素 

分 类 号：R722.18[医药卫生—儿科]