血清抗体、血红蛋白、胆红素、心肌酶及肝酶联合对新生儿Rh溶血病的诊断效果  

Application of combined detection of serum antibodies,hemoglobin,bilirubin,myocardial enzymes,and liver enzymes in the diagnosis of neonatal Rh hemolytic disease

作　　者：欧阳福连[1] 黄郁波[1] 董显燕[1] 肖宜春 钟涛[1] OUYANG Fulian;HUANG Yubo;DONG Xianyan;XIAO Yichun;ZHONG Tao(Department of Pediatrics,Ganzhou People's Hospital,Jiangxi Province,Ganzhou341000,China)

机构地区：[1]江西省赣州市人民医院儿科,江西赣州341000

出　　处：《中国当代医药》2024年第26期72-75,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212407)。

摘　　要：目的研究血清抗体、血红蛋白、胆红素、心肌酶及肝酶联合对新生儿Rh溶血病的诊断效果。方法选择2021年7月至2022年11月于赣州市人民医院分娩的53例新生儿Rh溶血病患儿,按照疾病严重程度分为重症组20例和轻症组33例,检测并比较血清抗体、血红蛋白、胆红素、心肌酶及肝酶水平,分析其诊断价值。结果重症组血红蛋白低于轻症组,胆红素、肌酸激酶、丙氨酸氨基转移酶高于对照组(P<0.05);两组血清抗体比较,差异无统计学意义(P>0.05);经logistic多因素分析结果显示,血清血红蛋白(β=-0.136,OR=0.873,95%CI:0.814~0.936)是新生儿Rh溶血病的保护因素(P<0.05);胆红素(β=0.031,OR=1.032,95%CI:1.012~1.052)、肌酸激酶(β=0.093,OR=1.098,95%CI:1.039~1.160)及丙氨酸氨基转移酶(β=0.120,OR=1.128,95%CI:1.042~1.221)是新生儿Rh溶血病的危险因素(P<0.05);绘制ROC曲线图,结果显示,血清血红蛋白、胆红素、心肌酶及肝酶联合检测在新生儿Rh溶血病诊断中的AUC分别为0.938、0.817、0.815、0.929、0.977,均有一定诊断价值。结论血清血红蛋白、胆红素、心肌酶及肝酶联合检测在新生儿Rh溶血病诊断中有一定应用价值。Objective To study the diagnostic effect of serum antibody,hemoglobin,bilirubin,myocardial enzyme and liver enzyme on Rh hemolytic disease of newborn.Methods From July 2021 to November 2022 in Ganzhou People's Hospital,53 cases of neonatal Rh hemolytic disease were selected and divided into severe group(20 cases)and mild group(33 cases)according to the severity of the disease.The levels of serum antibody,hemoglobin,bilirubin,myocardial enzyme and liver enzyme were detected and compared,and the diagnostic value was analyzed.Results Hemoglobin in severe group was lower than that in mild group,while bilirubin,creatine kinase and alanine aminotransferase in severe group were higher than those in control group(P<0.05).There was no significant difference in serum antibody between the two groups(P>0.05).The results of logistic multivariate analysis showed that serum hemoglobin(β=-0.136,OR=0.873,95%CI:0.814-0.936)was the protective faotor of Rh hemolytic disease in neonate(P<0.05),bilirubin(β=0.031,OR=1.032,95%CI:1.012-1.052),creatine kinase(β=0.093,OR=1.098,95%CI:1.039-1.160)and alanine aminotransferase(β=0.120,OR=1.128,95%CI:1.042-1.221).The ROC curve was drawn.The results showed that the AUC of combined detection of serum hemoglobin,bilirubin,myocardial enzyme and liver enzyme in the diagnosis of RH hemolytic disease of newborn were 0.938,0.817,0.815,0.929 and 0.977,respectively,which had certain diagnostic value.Conclusion The combined detection of serum hemoglobin,bilirubin,myocardial enzyme and liver enzyme has certain application value in the diagnosis of Rh hemolytic disease of newborn.

关 键 词：新生儿RH溶血病 抗体 血红蛋白 胆红素 心肌酶 肝酶 

分 类 号：R556.63[医药卫生—血液循环系统疾病]