黔江区某三甲医院新生儿溶血病实验室检测结果分析

doi:10.3969/j.issn.1006-6233.2018.11.043

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摘要 目的: 分析黔江区新生儿溶血病(HDN)的实验室检测结果,研究HDN血型分布和溶血三项试验诊断HDN的临床价值。方法: 对2012年8月至2016年8月黔江区某三甲医院产科、儿科疑似HDN标本1147例,应用微柱凝胶法技术行溶血三项试验,即直接抗人球蛋白试验(DAT)、游离抗体试验(FAT)、抗体放散试验(ART)检查,分析检查情况。结果: 1147例标本中,母婴血型不合788例(68.70%),HDN阳性481例,阳性率为61.04%(481/788)。481例确诊的HDN中溶血三项试验检查结果为DAT阳性率为28.27%(136/481),FAT阳性率为86.90%(418/481),ART阳性率为100%。与其他三种组合相比,FAT+ART组合阳性率均明显增高(P<0.05)。788例血型不合标本中,ABO-HDN阳性率为73.01%(468/641),明显高于Rh-HDN阳性率[8.84%(13/147)](P<0.05)。641例ABO血型系统不合标本中,A型HDN阳性率为81.46%(246/302),明显高于B型HDN阳性率[66.08%(224/339)](P<0.05)。147例Rh血型系统不合标本中,Rh D-HDN阳性率为16.18%(11/68),明显高于Rh E-HDN阳性率[3.92%(2/51)]或Rh C-HDN阳性率[0%(0/28)],差异均有统计学意义(P<0.05)。结论: 溶血三项试验中,以ART敏感度最高,是诊断HDN最强力证据。HDN发生率上,母婴ABO血型不合显著高于Rh血型不合,且ABO血型系统中A型明显高于B型,Rh血型系统中以Rh D最高。

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关键词 ：新生儿溶血病, 溶血三项试验, 微柱凝胶检测技术, 黔江地区

Abstract：Objective: To analyze the laboratory test results of hemolytic disease of newborn (HDN) in Minjiang District, and to study the clinical value of blood group distribution and hemolysis three tests in the diagnosis of HDN. Methods: A total of 1,147 suspected HDN samples were collected from the Department of Obstetrics and Pediatric Department of Minjiang Central Hospital from August 2012 to August 2016. The hemolysis three tests, namely, direct antiglobulin test (DAT), free antibody test (FAT) and antibody released test (ART) were performed by the micro-column gel technique, and results were analyzed. Results: Of the 1,147 samples, there were 788 cases (68.70%) of maternal- fetal blood group incompatibility, 481 cases of positive HDN and the positive rate was 61.04% (481/788). Results of hemolysis three tests of 481 cases with HDN showed that the positive rates of DAT, FAT and ART were 28.27% (136/481), 86.90% (418/481) and 100%, respectively. Compared with the other three kinds of combination, the positive rate of FAT+ART was significantly higher (P<0.05). In 788 specimens of blood group incompatibility, the positive rate of ABO-HDN was significantly higher than that of Rh-HDN [73.01% (468/641) vs 8.84% (13/147)] (P<0.05). The positive rate of type A HDN was 81.46% (246/302) in 641 ABO blood group incompatibility specimens, which was significantly higher than that of type B HDN [66.08% (224/339)] (P<0.05). In 147 Rh blood group incompatible specimens, the positive rate of Rh D-HDN was 16.18% (11/68), which was significantly higher than Rh E-HDN positive rate [3.92% (2/51)] or Rh C-HDN positive rate [0% (0/28)] (P<0.05). Conclusion: In the hemolysis three tests, the sensitivity of ART is the highest, which is the strongest evidence for the diagnosis of HDN. The incidence of HDN is significantly higher in mothers and infants with ABO blood group incompatibility than in those with Rh blood group incompatibility, and type A is significantly higher than type B in ABO blood group system. Rh D is the highest in Rh blood group system.

Key words： Hemolytic disease of newborn Hemolysis three tests Micro-column gel technique Lijiang district

基金资助:重庆市医学科研项目,(编号:20143032)

通讯作者: 冉柏林

引用本文:

李洪兵,冉柏林,王纯,陈周,文玲,蒲向阳. 黔江区某三甲医院新生儿溶血病实验室检测结果分析[J]. 河北医学, 2018, 24(11): 1933-1936.
LI Hongbing, RAN Bolin, WANG Chun, et al. Effects of Laboratory Diagnosis of Hemolytic Disease of Newborn in Minjiang District. HeBei Med, 2018, 24(11): 1933-1936.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.11.043 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I11/1933

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