血常规及生化指标联合函数对新生儿溶血病的辅助诊断价值研究  

The Value of the Combination Index of Blood Routine and Biochemical Examination in Diagnosing Hemolytic Disease of Newborn

作　　者：方超 刘磊[1] 曹媛 马超[1] 刘会兰 FANG Chao;LIU Lei;CAO Yuan;MA Chao;LIU Huilan(Department of Blood Transfusion,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)输血科,安徽合肥230001

出　　处：《临床输血与检验》2024年第6期766-771,共6页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探究血常规及生化指标构建的联合函数在基层医院筛查新生儿溶血性疾病(HDN)的辅助诊断价值。方法收集并回顾性分析2020年8月—2023年5月在中国科学技术大学附属第一医院出生并住院新生儿的标本及病历资料,根据临床诊断分为HDN组和非HDN组,统计分析血常规、生化及溶血三项等检查结果,并使用曲线下面积(AUC)评价逻辑回归构造的联合函数对于HDN的诊断效能。结果统计分析发现,母婴血型为O-A型发生HDN的可能性更高。通过对单一血常规及生化指标分析,发现与非HDN患儿相比,HDN患儿的白细胞计数(WBC)、血小板计数(PLT)、红细胞体积分布宽度(RDW)、平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)、血糖(GLU)、球蛋白(GLO)以及新生儿胆红素(NBIL)水平均显著升高,而红细胞计数(RBC)、血红蛋白含量(HB)和红细胞压积(HCT)水平显著降低(P<0.05)。为了得出更便捷高效的辅助诊断方式,利用逻辑回归构造函数联合各血常规及生化指标,将反映HDN诊断效能的AUC提升至0.77(0.72~0.78,P<0.05)。结论联合血常规及生化指标构建函数有助于早期筛查和诊断HDN,为基层医院HDN的筛查和诊断提供了新的思路。Objective To explore the value of blood examination results in diagnosing hemolytic disease of newborn in primary hospitals.Methods Neonates cases born and hospitalized in the First Affiliated Hospital of University of Science and Technology of China from August 2020 to May 2023 were collected and analyzed.All the cases were grouped by clinical diagnosis.The clinical symptoms,blood routine and biochemical examination results were analyzed.The area under the curve(AUC)was used to evaluate the diagnostic efficiency of the combination index by logistic regression.Results The statistical analysis shows that ABO incompatibility were more likely to occur in O-A setting Neonates.Compared with HDN patients,The levels of white blood cell count(WBC),platelet count(PLT),red blood cell distribution width(RDW),erythrocyte mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),blood glucose(GLU),globulin(GLO)and neonatal bilirubin(NBIL)in HDN group were significantly higher than non-HDN group.Red blood cell count(RBC),hemoglobin(HB)and Red blood cell specific volume(HCT)were significantly lower than those in the HDN group.In order to find a more convenient and efficient auxiliary diagnosis method,the blood examination was combined and the diagnosis efficiency of HDN was increased to 0.77(0.72~0.78,P<0.05).Conclusion The combination index of blood examination results has well performance at early diagnosis of HDN.It provides a new idea for screen or/and diagnosis of hemolytic disease of newborn in primary hospitals.

关 键 词：新生儿溶血病 血常规 生化检查 基层医院 

分 类 号：R446[医药卫生—诊断学]