血型血清学诊断新生儿溶血病的回顾性分析

目的：探索临沂市母婴ABO血型不合的新生儿溶血病的发病率及溶血三项试验的重要性，为临床提供新生儿溶血病的诊断依据。方法应用微柱凝胶技术对在2010年4月～2013年4月间收集的780份临床疑似新生儿溶血病患儿血样进行溶血三项试验。结果在780例新生儿标本中总阳性率为40．26％（314/780），其中A型139例，阳性率为44．27％（139/314），B型150例，阳性率为47．77％（150/314），二者差异无统计学意义（ P ＞0．05）。在阳性患者中，直接抗人球蛋白试验阳性率17．20％（54/314），血清游离抗体试验阳性率73．89％（232/314），抗体释放试验阳性率93．31％（293/314）。日龄不超过6d者阳性率是41．26％，日龄超过6d者阳性率是19．44％，日龄不超过6d者各项试验阳性率均高于超过6d（ P ＜0．05）。由母婴ABO血型不合引起的新生儿溶血病（HDN）的血型分布差异无统计学意义（ P ＞0．05）。结论血清学三项试验是诊断ABO新生溶血病的准确方法，其中抗体释放试验敏感度最高，是判定新生儿溶血病最有力的证据。对ABO新生儿溶血病的早期诊断、评估疾病程度、选择治疗方案等有其特殊的意义。

RETROSPECTIVE ANALYSIS OF SEROLOGICAL DIAGNOSIS OF HEMOLYTIC DISEASE OF TNEWBORN

Objective To explore the incidence of hemolytic disease of newborn （HDN）caused by mother-infant blood type incompatibility and to discover the importance of hemolysis tests for the diagnosis of HDN .Methods Hemolysis tests were performed with microcolumn gel technology for 780 newborns of clinical suspected HDN children from April ,2010 to April ,2013 .Results The total positive rate was 40 . 26% （314/780） in the 780 cases newborn ,including 139 cases of Type A with the positive rate being 44 . 27% （138/314） ,150 cases of Type B with the positive rate being 47 .77% （150/314）） and the difference be-tween them was not statistically significant （ P 〉0 .05） .Among the positive patients ,the positive rates from direct antiglobulin test ,free antibody test and antibody release test were 17 .20% （54/314） ,73 .89%（232/314）and 93 .31% （293/314）respectively .The positive rate in newborns of no not more than 6 days was 41 .26% ,the positive rate in newborns of more than 6 days was 19 .44% ,and the positive rate in new-borns no not more than 6 days were higher than that in new borns more than 6 days（ P 〈0 .05） .No significant difference in blood type distribution was found in the cases of HDN caused by mother-infant blood type in-compatibility（ P 〉 0 .05） .Conclusion Hemolysis tests for early diagnosis of HDN is accurate and can help to evaluate the process of disease and choose the appro-priate therapy ,and antibody release test has especially high sensitivity .