570例高胆红素血症血清学检测结果的临床分析

目的对昆明地区570例高胆红素血症新生儿血液标本进行血清学检测，评价“三项试验”在HDN诊断中的价值．方法采用直接抗球蛋白试验（DAT）、游离抗体检测和红细胞抗体释放试验；对本地区医院送检的新生儿血液标本进行检测．结果在570例高胆红素血症新生儿血液标本中，确诊的HDN有397例，其“三项试验”结果呈阳性所占比例分布规律为：单项释放试验阳性率〉直抗试验、游离试验阳性率〉直抗试验、游离试验、释放试验阳性率，总体差异有统计学意义（P〈0．05）．397例HDN患儿中，血型分布规律为：A〉B〉AB，其中A型56．42％；B型41．06％；AB型2．52％，但差异均无统计学意义（P〉0．05）．本组数据还显示A型女婴发病率高于男婴，B型男婴发病率高于女婴，但差异无统计学意义（P〉0．05）．结论昆明地区A型新生儿患HDN机率相对较高，“三项试验”在HDN的诊断中具有重要的临床诊断价值，其抗体释放试验敏感性最强，是判定HDN最有力的证据．

Clinical Analysis of Serological Examination Results from 570 Patients with Hyperbilirubinemia

Objective To evaluate the diagnostic value of three serological examination in hemolytic disease of newborn （HDN）. Methods Serological examination of 570 patients with hyperbilirubinemia in Knnming was performed according to the DAT, serum free experiment and liberate experiment. Results There were 397 diagnosed HDN in the 570 blood sample from patients with hyperbilirubinemia. The distribution of positive rates in the three serological examination were： simple serum liberate experiment 〉 DAT, serum free experiment 〉 DAT, serum free experiment and liberate experiment. The difference had statistical significance P 〈 0.05. The distribution of blood types in 397 patients with HDN were： A （56.42%） 〉 B （41.06%） 〉 AB （2.52%）. The difference had no statistical significance P 〉 0.05. Conclusions The A blood type newborns have higher HDN prevalence. It is very important for three serological examination to diagnose HDN. The sensitivity of serum liberate experiment is the highest.