Blood group serological detection technology for the diagnosis of hemolytic disease in newborns
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摘要: 目的:探讨血清学检测技术对新生儿溶血病(HDFN)的诊断价值。方法:收集2016-07-11-2017-02-10陕西省人民医院产科及新生儿科患有高胆红素血症的新生儿1 000例患儿样本,对其进行血型鉴定、不规则抗体筛查检测、直接抗人球蛋白试验、游离抗体试验以及抗体释放试验检测。结果:①母婴血型不合者615例,以病历出院诊断确诊HDFN患儿281例(45.7%)。② 615例母婴血型不合患者中,ABO、Rh系统HDFN发生率分别为50.57%(267/528)、16.09%(14/87),比较差异有统计学意义(P<0.05)。③ABO血型系统母婴血型不合者528例,A、B型血发病率分别为62.2%及41.4%,差异有统计学意义(P<0.05)。④在确诊的281例HDFN患者中,血清学试验3项(直接抗人球蛋白试验、抗体释放试验阳性、游离抗体试验)均为阳性结果占1.8%;直接抗人球蛋白试验阴性而其余为试验阳性结果占3.6%;游离抗体实验阴性而其余为试验阳性结果占7.1%;单独抗体释放试验阳性结果占87.5%。⑤528例O型母亲血清中Ig-G抗A(B)效价 ≥ 64的有216例,确诊为HDFN为174例(80.6%);Ig-G抗A(B)<64的有312例,确诊为HDFN的有93例(29.8%),差异有统计学意义(P<0.05)。结论:血清学检测技术对HDFN诊断起到一定辅助作用。Abstract: Objective:To investigate the diagnostic value of serological detection and detection technique for hemolytic disease of the newborn(HDFN).Method:A total of 1 000 newborns with hyperbilirubinemia in the department of obstetrics and neonatology of Shaanxi Provincial People's Hospital were collected from 2016-07-11-2017-02-10.Blood group identification and screening for irregular antibodies were performed,direct anti-human globulin test,free antibody test and antibody release test.Result:①There were 615 cases with maternal and neonatal blood group incompatibility,and 281 cases(45.7%)were diagnosed with HDFN by medical records.The incidence of HDFN in ABO and Rh system was 50.57%(267/528)and 16.09%(14/87).②The 615 cases of maternal and neonatal blood type incompatibility respectively.The difference was statistically significant(P<0.05).③The 528 cases of maternal and neonatal blood type mismatch in ABO blood type system,the incidence rate of type A and type B blood were 62.2% and 41.4% respectively.The difference was statistically significant(P<0.05).④Of the 281 HDFN patients diagnosed,3 were serological tests(direct antiglobulin test,positive antibody release test,and free antibody test)with positive results of 1.8%;direct antiglobulin test was negative and the rest were The positive result of the test accounted for 3.6%;the free antibody test was negative and the remaining test positive result was 7.1%;the positive result of the single antibody release test accounted for 87.5%.There were 216 Ig-G anti-A(B)titers in the serum.⑤The 528 type O mothers,of which 174(80.6%)were diagnosed with HDFN,and 312 were Ig-G anti A(B)<64.There were 93 cases(29.8%)diagnosed with HDFN,and the difference was statistically significant(P<0.05).Conclusion:Serological detection technologycan play an important role in the diagnosis of HDFN.
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Key words:
- neonatal hemolytic disease /
- hemolysis 3 tests /
- antibody titers
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[1] Yousuf R,Abdul Aziz S,Yusof N,et al.Hemolytic disease of the fetus and newborn caused by anti-D and anti-S alloantibodies:a case report[J].J Med Case Rep,2012,6:71.
[2] Akanmu AS,Oyedeji OA,Adeyemo TA,et al.Estimating the Risk of ABO Hemolytic Disease of the Newborn in Lagos[J].J Blood Transfus,2015;2015:560738.
[3] 李建刚,付超,姚锁良,等.ABO型新生儿溶血症筛查结果分析[J].临床血液学杂志(输血与检验),2014(6):1009-1011.
[4] 张勇萍,杨世明,安宁,等.母婴血型不合新生儿溶血病及其血型血清学检测的临床意义[J].细胞与分子免疫学杂志,2013,29(11):1229-1231.
[5] 杨冬梅,李志坚.不规则抗体致新生儿溶血病的检测结果分析[J].中国药物与临床,2016,16(3):438-439.
[6] Centers for Disease Control and Prevention (CDC).Kernicterus in full-term infants--United States,1994-1998[J].MMWR Morb Mortal Wkly Rep,2001,50:491-494.
[7] 胡亚美,诸福棠.实用儿科学[M].7版.北京:人民卫生出版社,2002.
[8] Handley SC,Posencheg MA.Hemolytic Disease of the Fetus and Newborn[M]//Neonatal Transfusion Practices.Springer International Publishing,2017.
[9] 张泉,周金安.6000例新生儿溶血病标本血型抗体分析[J].临床血液学杂志(输血与检验),2017(6):975-976.
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