溶血三项联合血清胆红素检测对高胆红素血症新生儿溶血病的诊断价值  

Diagnostic value of three hemolysis tests combined with serum bilirubin detection for hemolytic disease of newborn with hyperbilirubinemia

作　　者：胡彩玲 Hu Cailing(Department of Clinical Laboratory,Meizhou Maternal and Child Health Hospital,Meizhou 514000,Guangdong,China)

机构地区：[1]梅州市妇幼保健院检验科,广东梅州514000

出　　处：《实用检验医师杂志》2025年第1期52-55,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的研究溶血三项(直接抗人球蛋白试验、血清游离抗体试验、抗体释放试验)联合血清胆红素检测对高胆红素血症新生儿溶血病(HDN)的诊断价值。方法采用回顾性研究方法,收集并分析2022年6月—2023年4月于梅州市妇幼保健院产科出生的100例新生儿的临床资料,根据母婴血型不同分为O-A/B血型不同组(55例)和O-O血型相同组(45例);比较两组血清胆红素水平、溶血三项阳性率和高胆红素血症HDN发生率。根据溶血三项结果不同将新生儿分为A组〔1例;直抗试验(+)、游离试验(+)、释放试验(+)〕、B组〔10例;直抗试验(+)、游离试验(-)、释放试验(+)〕、C组〔13例;直抗试验(-)、游离试验(+)、释放试验(+)〕、D组〔8例;直抗试验(-)、游离试验(-)、释放试验(+)〕、E组〔68例;直抗试验(-)、游离试验(-)、释放试验(-)〕;比较各组血清胆红素水平。根据血清胆红素水平将新生儿分为0~21μmol/L组(4例)、>21~35μmol/L组(49例)、>35~45μmol/L组(33例)、>45~55μmol/L组(10例)和>55μmol/L组(4例),比较各组高胆红素血症HDN发生率。采用诊断试验分析溶血三项联合血清胆红素检测对高胆红素血症HDN的诊断价值。结果新生儿高胆红素血症HDN发生率为32.00%(32/100)。O-A/B血型不同组血清胆红素水平显著高于O-O血型相同组(μmol/L:37.80±10.25比33.79±8.16,P<0.05)。O-A/B血型不同组的游离抗体试验和抗体释放试验阳性率、高胆红素血症HDN发生率均明显高于O-O血型相同组(游离试验阳性率:25.45%比2.22%;释放试验阳性率:32.73%比2.22%;高胆红素血症HDN发生率:45.45%比15.56%;均P<0.05〕。A组、B组、C组、D组血清胆红素水平均显著高于E组(μmol/L:39.3、47.46±12.05、45.31±10.28、34.62±7.82比22.57±4.38,均P<0.05),B组和C组血清胆红素水平比较差异无统计学意义,均显著高于D组(均P<0.05)。血清胆红素>55μmol/L组的高胆红素血症HDN发生率显著高于0~21μmol/L�Objective To study the diagnostic value of three hemolysis tests(direct anti-human globulin test,serum free antibody test,antibody release test)combined with serum bilirubin detection for hemolytic disease of newborn(HDN)with hyperbilirubinemia.Methods The clinical data of 100 newborns in obstetrics department of Meizhou Maternal and Child Health Hospital from June 2022 to April 2023 were collected and analyzed retrospectively.They were divided into different O-A/B blood type group(55 cases)and same O-O blood type group(45 cases)according to maternal and infant blood types.The level of serum bilirubin,positive rates of three hemolysis tests and incidence of HDN with hyperbilirubinemia were compared between two groups.According to the results of three hemolysis tests,the children were divided into group A[1 case;direct antibdy test(+),free antibdy test(+),antibdy release test(+)],group B[10 cases;direct antibdy test(+),free antibdy test(-),antibdy release test(+)],group C[13 cases;direct antibdy test(-),free antibdy test(+),antibdy release test(+)],group D[8 cases;direct antibdy test(-),free antibdy test(-),antibdy release test(+)]and group E[68 cases;direct antibdy test(-),free antibdy test(-),antibdy release test(-)].The serum bilirubin levels were compared among all groups.According to serum bilirubin level,the newborns were divided into 0-21μmol/L group(4 cases),>21-35μmol/L group(49 cases),>35-45μmol/L group(33 cases),>45-55μmol/L group(10 cases)and>55μmol/L group(4 cases),and the incidence of HDN with hyperbilirubinemia was compared.The diagnostic value of three hemolysis tests combined with serum bilirubin detection for HDN with hyperbilirubinemia was analyzed using diagnostic tests.Results The incidence of HDN with hyperbilirubinemia was 32.00%(32/100).The serum bilirubin level in different O-A/B blood type group was higher than that in same O-O blood type group(μmol/L:37.80±10.25 vs.33.79±8.16,P<0.05).The positive rates of free antibody test and antibody release test and the incidence of HDN with

关 键 词：高胆红素血症 新生儿溶血症 直接抗人球蛋白试验 血清游离抗体试验 抗体释放试验 血清胆红素 

分 类 号：R722.17[医药卫生—儿科]