母婴ABO血型不相合的高胆红素血症患儿新生儿溶血病确诊率的影响因素分析

目的研究患儿性别、日龄、母婴血型类型及总胆红素水平是否为确诊ABO新生儿溶血病(ABOHDN)的影响因素。方法收集该院2015年1月至2017年12月母婴ABO血型不相合新生儿高胆红素血症患儿2501例,通过血清学3项试验诊断是否为ABO-HDN,并通过χ^2检验、分层χ^2检验、Bonferroni校正检验和二元Logistic回归分析进行统计分析。结果2501例病例中ABO-HDN确诊率为69.97%(1750/2501),其中女婴确诊率为74.18%(859/1158),高于男婴的66.34%(891/1343,P<0.001),分层χ^2检验中只有日龄<4d组男女确诊率差异有统计学意义(P=0.003);患儿血型A型确诊率(79.66%)高于B型(71.05%),包括母婴血型模式O-A(84.71%)高于O-B(76.46%),B-A(10.00%)高于A-B(1.23%);日龄<4d、4~7d和>7d3组患儿确诊率分别为82.08%、66.27%和46.86%,经Bonferroni校正检验,差异有统计学意义(P<0.001),即日龄越小,确诊率越高;二元Logistic回归分析显示患儿日龄、母婴血型类型和总胆红素水平是确诊ABO-HDN的独立影响因素(P<0.001)。结论患儿日龄、母婴血型类型及总胆红素水平是确诊ABOHDN的独立影响因素。

Factors affecting HDN diagnosis of maternal-infant ABO-incompatible hyperbilirubinemia

Objective To investigate the influences in the diagnosis of ABO-HDN on infant patients′gender,age,maternal-infant blood type and the level of total bilirubin.Methods A total of 2501 hyperbilirubinemia of newborn with maternal-infant ABO-incompatible were collected in our hospital from January 2015 to December 2017.A total of 2501 samples were subjected to three serological tests respectively,to confirm whether they suffered from ABO-HDN,and analysis was performed by chi-square test,hierarchical chi-square test,bonferroni correction test and binary Logistic regression analysis.Results Among the 2501 cases,1750 were diagnosed as ABO-HDN with 69.97%positive rate,of which,the positive percentage is higher in female(74.18%)than male(66.34%),whereas there was significant difference,only in group of less than 4 days,in hierarchical chi-square test(P=0.003).The positive rate of group A(79.66%)was higher than that of group B(71.05%),including that of O-A(84.71%)and B-A(10.00%)was higher than that of O-B(76.46%)and A-B(1.23%)respectively.The positive rates of group of<4 days,4-7 days and>7 days were 82.08%,66.27%and 46.86%respectively,the differences were statistically significant clarified by bonferroni correction test(P<0.001).That is to say,the younger the patient was,the higher the positive rate was.The age,maternal-infant blood group and the level of total bilirubin were independent factors influencing the diagnosis of ABO-HDN analyzed by binary Logistic regression(P<0.001).Conclusion Infant patients′age,maternal-infant blood group and the level of total bilirubin were independent influencing factors for diagnosis of ABOHDN.