Rh血型系统新生儿溶血病的实验诊断及特殊反应分析

目的探讨Rh血型系统新生儿溶血病的实验诊断和特殊试验结果分析。方法收集Rh系统新生儿溶血病标本12例,母血标本12例,测定其ABO和Rh血型。新生儿标本行溶血病3项实验,新生儿血清、放散液、母血清行不规则抗体筛选和鉴定实验,并测定相应抗体的效价。结果有1例患儿标本RhD血型放散前定型为阴性,放散后为阳性;患儿标本溶血病3项实验均阳性;引起溶血病的抗体中,IgG抗-D 9例,IgG抗-E检出2例,IgG抗-c合并抗-D1例;母血清中的IgG抗-D效价介于128~2048,IgG抗-E效价介于64~256;患儿血清中游离的IgG抗-D效价介于2~512,IgG抗-E效价介于4~32。结论直接抗人球蛋白实验和放散实验对于诊断Rh系统溶血病具有重要意义;特殊反应要综合分析处理,获取真实结果;临床输血或换血治疗时,要根据患儿体内的抗体情况进行血液选择。

Experimental diagnosis and special test result analysis for hemolytic disease of newborn of Rhesus blood group

Objective To discuss the experimental diagnosis for hemolytic disease of the newborn of Rhesus system and the analysis of special test results.Methods The 12 newborn patients’ and their mother’s ABO and Rhesus blood group were typed with serologic method after the specimens had been collected.The direct antiglobulin test,free antibody determination test and elution test were done for newborns’ specimens.Irregular antibody screen test and identification test were performed with patients’ sera,elutions and mothers’ sera,and then antibody titrations were determined.Results One patient’s Rhesus D serotype was different in pre-and post-elution.Tests for hemolytic disease were positive in all specimen,9 patients were provoked due to anti-D,2 patients due to anti-E,while 1 patient was provoked due to anti-c in combination with anti-D.The anti-D titration were various from 128 to 2048 in mothers’ sera while from 2 to 512 in newborns’ sera.The anti-E titrations were diverse from 64 to 256 in mothers’ sera but from 4 to 32 in newborns’ sera.Conclusions The direct antiglobulin test and elution test were important for diagnosing hemolytic disease of the newborn of Rhesus system.Special test results should be analyzed and dealt comprehensively.Irregular antibodies titration should be considered in the blood selection for transfusion or exchange transfusion.