母体血清免疫球蛋白G抗A/B抗体联合脐带血总胆红素对新生儿溶血病的诊断价值  

Diagnostic Value of Maternal Serum Immunoglobulin G Anti-A/B Antibody Combined with Cord Blood Total Bilirubin for Hemolytic Disease of Newborns

作　　者：吉小军 张明敏 陈袁园 JI Xiaojun;ZHANG Mingmin;CHEN Yuanyuan(Department of Pediatrics,Haian People's Hospital,Haian,Jiangsu 226600,China)

机构地区：[1]海安市人民医院儿科,江苏海安226600

出　　处：《临床误诊误治》2025年第3期78-82,共5页Clinical Misdiagnosis & Mistherapy

基　　金：南通市卫生健康委员会科研课题(QB2020014)。

摘　　要：目的探究母体血清免疫球蛋白G(IgG)抗A/B抗体联合新生儿脐带血总胆红素对新生儿溶血病(HDN)的诊断价值。方法收集2019年4月至2024年4月收治的母婴血型不合所致HDN新生儿82例为观察组,选择同期母婴血型不合健康新生儿77例为对照组。对比2组新生儿母体分娩前血清IgG抗A/B抗体效价及脐带血总胆红素水平。绘制受试者工作特征(ROC)曲线,分析IgG抗体效价、脐带血总胆红素及二者联合对HDN的诊断价值。结果观察组母体血清IgG抗A/B抗体效价≤1∶32、1∶64的占比[3.66%(3/82)、8.54%(7/82)]低于对照组[48.05%(37/77)、24.68%(19/77)],1∶256、≥1∶512的占比[31.71%(26/82)、35.37%(29/82)]高于对照组[5.19%(4/77)、3.90%(3/77)],差异有统计学意义(P<0.05);观察组脐带血总胆红素水平[(34.38±7.28)μmol/L]高于对照组[(23.96±5.73)μmol/L],差异有统计学意义(P<0.05);ROC曲线分析显示,血清IgG抗A/B抗体效价、脐带血总胆红素联合诊断HDN的效能高于单独诊断,其敏感度为90.22%,特异度为89.56%,曲线下面积为0.936。结论母体血清IgG抗A/B抗体联合脐带血总胆红素对HDN的诊断价值较高。Objective To investigate the diagnostic value of maternal serum immunoglobulin G(IgG)antiA/B anti-body combined with neonatal total serum bilirubin(TSB)in umbilical cord blood in hemolytic disease of the newborn(HDN).Methods A total of 82 HDN neonates with incompatibility between maternal and fetal blood admitted from April 2019 to April 2024 were selected as the observation group,and 77 healthy neonates with incompatibility between maternal and fetal blood during the same period were selected as the control group.The titer of serum IgG anti-A/B antibody and TSB in umbilical cord blood before delivery were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of IgG antibody titer,TSB in umbilical cord blood and their combination for HDN.Results The proportion of maternal serum IgG anti-A/B antibody titers≤1∶32 and 1∶64 in observation group[3.66%(3/82),8.54%(7/82)]was lower than that in control group[48.05%(37/77),24.68%(19/77)],and the proportion of 1∶256 and≥1∶512 in observation group[31.71%(26/82),35.37%(29/82)]was higher than that in control group[5.19%(4/77),3.90%(3/77)],showing significant differences(P<0.05).The level of TSB in umbilical cord blood of observation group[(34.38±7.28)μmol/L]was higher than that of control group[(23.96±5.73)μmol/L],showing sig-nificant differences(P<0.05).ROC curve analysis showed that the efficacy of serum IgG anti-A/B antibody titer and TSB in umbilical cord blood in combination for the diagnosis of HDN was higher than that of single diagnosis,with the sensitivity of 90.22%,the specificity of 89.56%,and the area under the ROC curve of 0.936.Conclusion The diagnostic value of maternal IgG anti-A/B antibody combined with TSB in umbilical cord blood for HDN is higher.

关 键 词：免疫球蛋白G 抗A/B抗体 母婴血型不合 胎血 胆红素 新生儿溶血病 受试者工作特征曲线 诊断价值 

分 类 号：R722.18[医药卫生—儿科]