微柱凝胶技术应用于新生儿溶血病的实验室诊断

目的采用微柱凝胶技术进行新生儿溶血病（HDN）的实验室诊断分析。方法对1627例新生儿进行血型血清学分析,包括母婴血型、直接抗人球蛋白试验、血清游离抗体试验、热放散试验、ABO血型系统以外的抗体鉴定试验。结果 1627例病例中确诊为HDN的有163例,其中母-婴血型为O-A及O-B的最多,共占97.55%。确诊为HDN血清学结果中放散试验和游离抗体试验同时阳性最多,占76.07%。诊断为HDN可疑病例血清学结果中,直接抗人球蛋白试验阳性率最多,占79.55%。在出生后3～7d内确诊HND的患儿数最多,占66.26%。ABO血型系统以外的抗体鉴定试验阳性有6例,其中5例诊断为RhHDN。结论红细胞抗体释放试验、直接抗人球蛋白试验和血清游离抗体试验是早期诊断HDN的有效方法。HDN检出率与所采用的实验方法和采血时机有很大关系。

Application of Microcolumn Gel Test in Laboratory Diagnosis of Hemolytic Disease of the Newborn

Objective To evaluate the applicability of microcolumn gel test in laboratory diagnosis of hemolytic disease of the newborn.Method 1 627 newborn infants were subjected to serologic examination,these included the blood group typing,direct Coombs test,serum free antibody test,antibody releasing test and other antibody beside ABO blood group system.Results 163 out of 1 627 cases were verified as HDN,in which 97.55% of mother-infants blood group were O-A and O-B.76.07% had positive result in both red blood cell antibody release test and serum free antibody test of these HDN infants.The positive rate of the direct Coombs test was 79.55% in the suspected cases.66.26% of HDN was diagnosed at 3 to 7 days after born.6 positive cases in other antibody beside ABO blood group system,in which 5 cases were diagnosed as Rh HDN.Conclusions Red blood cell antibody release test,direct Coombs test and serum free antibody test were effective methods in early diagnosis of HDN.The detection rate of HDN was largely related with the detection methods and the time of blood collection.