血常规、肝功能指标联合溶血三项试验在新生儿ABO溶血病中的临床应用  

Clinical application of routine blood test, liver function index combined with hemolysis three tests in neonatal ABO hemolytic disease

作　　者：谢铭江 俞育昌[1] 吴建宁[2] XIE Mingjiang;YU Yuchang;WU Jianning(Department of Paediatrics,the Second Hospital of Longyan City,Fujian Province,Fujian Province,Longyan364000,China;Longyan Xinluo District Center for Disease Control and Prevention,Fujian Province,Longyan364000,China)

机构地区：[1]福建省龙岩市第二医院儿科,福建龙岩364000 [2]福建省龙岩市新罗区疾病预防控制中心,福建龙岩364000

出　　处：《中国当代医药》2024年第27期95-99,共5页China Modern Medicine

摘　　要：目的探索血常规、肝功能指标在新生儿ABO溶血病(ABO-HDN)中的临床特点,为临床诊断ABO-HDN提供参考。方法对2019年1月至2022年12月福建省龙岩市第二医院儿科病房收治的406例新生儿高胆红素血症患儿进行回顾性分析,其中满足ABO-HDN诊断标准的50例患儿设为溶血组,选取同期匹配的201例非ABO-HDN患儿为非溶血组。比较两组患儿的肝功能、血常规相关指标,绘制有统计学差异指标的AUC曲线,筛选效能较好的指标,比较指标与溶血三项实验的诊断效能,并分析联合溶血三项实验的检验效能。结果溶血组患儿的血清总蛋白、血清白蛋白、白细胞计数、血小板计数、淋巴细胞计数高于非溶血组(P<0.05);绘制有统计学意义指标的ROC曲线发现仅血红蛋白计数的ROC曲线下的面积在0.7以上,95%CI为0.627~0.784,血红蛋白阳性结果截断值为163.5 g/L;血红蛋白计数单独及联合Coombs'试验的Youden's指数分别为39%,84%。结论血红蛋白计数低于163.5 g/L对ABO-HDN具有一定预测价值,血红蛋白并联Coombs'试验可降低ABO-HDN的漏诊率。Objective To explore the clinical characteristics of blood routine and liver function indexes in neonatal ABO hemolytic disease(ABO-HDN),and to provide reference for clinical diagnosis of ABO-HDN.Methods A retrospective analysis was performed on 406 children with neonatal hyperbilirubinemia admitted to the pediatric ward of the Second Hospital of Longyan City,Fujian Province from January 2019 to December 2022.Among them,50 children who met the diagnostic criteria of ABO-HDN were selected as the hemolytic group,and 201 children with non ABO-HDN were selected as the non-hemolytic group.The liver function and blood routine related indicators of the two groups of children were compared.The AUC curve of the statistically different indicators was drawn to screen the indicators with better performance,and the diagnostic efficacy of the indicators and the three hemolysis experiments was compared.The test efficiency of combined hemolysis three experiments was analyzed.Results The serum total protein,serum albumin,white blood cell count,platelet count and lymphocyte count in the hemolytic group were higher than those in the non-hemolytic group,with statistically significant differences(P<0.05).The ROC curve of statistically significant indicators showed that only the area under the ROC curve of hemoglobin count was above 0.7,95%CI was 0.627-0.784,and the cut-off value of hemoglobin positive results was 163.5 g/L;the Youden's index of hemoglobin count alone and in combination with Coombs'test were 39%and 84%,respectively.Conclusion Hemoglobin count less than 163.5 g/L has a certain predictive value for ABO-HDN.Hemoglobin parallel Coombs'test can reduce the missed diagnosis rate of ABO-HDN.

关 键 词：新生儿ABO溶血病 溶血三项 血红蛋白计数 灵敏度 特异度 

分 类 号：R722[医药卫生—儿科]