2208例疑似新生儿溶血病血清学检测结果分析

目的探讨新生儿溶血病(HDN)血清学检测与患儿性别、血型、日龄之间的关系,分析溶血3项试验对HDN的诊断价值。方法对2208例疑似HDN患儿的血样标本进行ABO和Rh血型鉴定、直接抗人球试验、游离试验、释放试验检查,以上试验均采用微柱凝胶法检测。结果在2208例中,有1021例确诊为ABO-HDN。不同性别新生儿HDN阳性率差异有统计学意义(χ^2=15.461,P=0.000);A型和B型患儿HDN阳性率差异有统计学意义(χ^2=25.714,P=0.000);随着患儿日龄增大,HDN阳性率逐渐降低。在确诊为ABO-HDN的患儿中,直抗试验阳性率为19.59%,游离试验阳性率为96.96%,释放试验阳性率为100.00%。结论HDN主要发生于ABO血型系统,患儿性别、血型与HDN阳性率与有关,患儿日龄越小,HDN阳性率越高。释放试验的准确率最高,且是诊断ABO-HDN的最有力证据。

Analysis of serological test results of 2280 suspected cases of hemolytic disease of newborn

Objective To explore the relationship between the serological detection of hemolytic disease of newborn(HDN)and the sex,blood type and age of the children,and to analyze the diagnostic value of three hemolytic tests for HDN.Methods ABO and Rh blood group identification,direct anti human cell test,free test and release test were carried out on the blood samples of 2208 suspected HDN patients.All the above tests were detected by microgel method.Results Of the 2280 cases,1021 were diagnosed as ABO-HDN.The positive rate of HDN was statistically significant(χ^2=15.461,P=0.000);the positive rate of HDN was statistically significant(χ^2=25.714,P=0.000)in type A and type B infants;the positive rate of HDN decreased with the increase of age.In the diagnosis of ABO-HDN,the positive rate of direct antiglobulin test was 19.59%,the positive rate of free anti-human globulin assay was 96.96%,and the positive rate of antibody release assay was 100.00%.Conclusion HDN mainly occurs in ABO blood group system.The gender,blood group and HDN positive rate are related to each other.The younger the children are,the higher the HDN positive rate is.The release test has the highest accuracy and is the most powerful evidence for the diagnosis of ABO-HDN.