新生儿ABO溶血病输血治疗前后网织红细胞参数、球形红细胞计数水平变化对治疗结局的评估价值  

Value of changes in reticulocyte parameters and spherocyte count levels before and after blood transfusion treatment for neonatal ABO hemolytic disease in evaluating treatment outcomes

作　　者：魏艺芳 王珊 钟丽慧 闫优萍 WEI Yi-fang;WANG Shan;ZHONG Li-hui;YAN You-ping(Department of Blood Transfusion,Zhumadian Central Hospital,Zhumadian 463000,Henan,CHINA;Department of Clinical Laboratory,Henan Children's Hospital(Zhengzhou Children's Hospital),Zhengzhou 450000,Henan,CHINA)

机构地区：[1]驻马店市中心医院输血科,河南驻马店463000 [2]河南省儿童医院(郑州儿童医院)检验科,河南郑州450000

出　　处：《海南医学》2024年第23期3420-3424,共5页Hainan Medical Journal

基　　金：2023年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20231012)。

摘　　要：目的探讨新生儿ABO溶血病(ABO-HDN)输血治疗前后网织红细胞(RET)参数、球形红细胞计数水平变化对治疗结局的评估价值。方法选取2019年1月至2024年1月驻马店市中心医院收治的127例需输血治疗的ABO-HDN患儿进行回顾性研究,根据治疗结局分为结局良好组104例与结局不良组23例。比较两组患儿的基线资料、输血前后的总胆红素(TBIL)、RET参数[RET计数百分比(RET%)、低荧光强度RET计数百分比(LFR%)、中荧光强度RET计数百分比(MFR%)、高荧光强度RET计数百分比(HFR%)、未成熟RET计数百分比(IRF%)]和球形红细胞计数水平及变化值(△值),采用Pearson分析RET参数、球形红细胞计数△值与TBIL△值的相关性,采用偏相关性分析RET参数、球形红细胞计数△值与治疗结局的关系,采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析RET参数、球形红细胞计数△值对治疗结局的评估价值。结果结局不良组患儿输血前后的LFR%明显低于结局良好组,TBIL、RET%、MFR%、HFR%、IRF%、球形红细胞计数明显高于结局良好组,且TBIL△值、RET%△值、LFR%△值、MFR%△值、HFR%△值、IRF%△值、球形红细胞计数△值均低于结局良好组,差异均有统计学意义(P<0.05);Pearson相关性分析结果显示,RET%△值、LFR%△值、MFR%△值、HFR%△值、IRF%△值、球形红细胞计数△值与TBIL△值呈正相关(r=0.706、0.611、0.603、0.625、0.618、0.607,P<0.05);偏相关性分析结果显示,RET%△值(95%CI:0.481~0.923)、LFR%△值(95%CI:0.522~0.957)、MFR%△值(95%CI:0.417~0.906)、HFR%△值(95%CI:0.398~0.915)、IRF%△值(95%CI:0.403~0.897)、球形红细胞计数△值(95%CI:0.460~0.933)与治疗结局呈显著相关(P<0.05);ROC曲线分析结果显示,RET%△值、LFR%△值、MFR%△值、HFR%△值、IRF%△值、球形红细胞计数△值联合评估治疗结局的AUC最大,明显大于各指标单独评估价值(P<0.05)。结论RET参数、球形红细胞计数与�Objective To explore the value of changes in reticulocyte(RET)parameters and spherocyte count for evaluating the treatment outcome of ABO hemolytic disease of the newborns(ABO-HDN)before and after blood transfusion therapy.Methods A retrospective study was conducted on 127 children with ABO-HDN who required blood transfusion treatment and were admitted to Zhumadian Central Hospital from January 2019 to January 2024.Ac-cording to the treatment outcomes,the children were divided into a good outcome group of 104 cases and an adverse out-come group of 23 cases.The baseline data,total bilirubin(TBIL)before and after transfusion,RET parameters(the frac-tion of reticulocytes[RET%],the fraction of low-fluorescence intensity reticulocytes[LFR%],the fraction of medi-um-fluorescence intensity reticulocytes[MFR%],the fraction of high-fluorescence intensity reticulocytes[HFR%],the fraction of immature reticulocytes[IRF%]),and spherocyte count levels and changes(△values)were compared be-tween two groups of patients.Pearson correlation analysis was used to determine the correlation between RET param-eters,△value of spherocyte count,and TBIL△value.Partial correlation analysis was performed to examine the relation-ship between RET parameters,spherocyte count△value,and treatment outcomes.Receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the value of RET parameters and spherocyte count△value for evaluating treatment outcomes.Results The LFR%before and after blood transfusion in the group with poor outcomes was significantly lower than that in the group with good outcomes;TBIL,RET%,MFR%,HFR%,IRF%,and spherocyte count were significantly higher than those in the group with good outcomes;the TBIL△value,RET%△val-ue,LFR%△value,MFR%△value,HFR%△value,IRF%△value,and spherocyte count△value were all lower than those in the group with good outcomes;the differences were statistically significant(P<0.05).Pearson correlation analy-sis showed that RET%△,LFR%△,MFR%△,HFR%△,I

关 键 词：新生儿ABO溶血病 输血 网织红细胞 球形红细胞计数 治疗结局 

分 类 号：R722.18[医药卫生—儿科]