某院新生儿溶血病血清学检测结果分析

Significance of serological testing in hemolytic disease of newborn

目的通过对该院新生儿溶血病(HDN)血型血清学检测结果的分析,掌握溶血三项试验(直接抗球蛋白试验、抗体释放试验、游离抗体试验)的检测时间和意义。方法对临床表现符合HDN的338例新生儿进行血型血清学检测,分析新生儿出生日龄对三项试验检出阳性率的影响以及实验诊断与临床表现的符合率。结果溶血三项试验阳性率随新生儿出生日龄的增加而降低,338例新生儿中,出生日龄小于或等于2d者比大于2d者三项试验的阳性率显著升高,差异有统计学意义(P<0.01),血清学检测HDN与临床表现的符合率为55.3%。结论母婴血型不合的新生儿应在出生2d内进行血清学检测,出生日龄大于2d后,免疫性血型抗体可被破坏使检测结果阴性,从而易造成临床误诊。

Objective To explore the opportunity and significance of hemolytic three trials by analyzing the serological detection results in patients with hemolytic disease of newborn（HDN）.Methods 338cases of newborn,with clinical manifestation of HDN,were enrolled and detected by serological detection.The influence of newborns’birth age on the positive rate of three trials,and the coincidence rate between laboratory diagnosis and clinical manifestations were also analyzed.Results The positive rate of hemolytic three trials decreased with the increasing of newborns’birth age.Among all 338cases of neonate,the positive rate of those equal with or less than 2days old was higher than that of those more than 2days old（P〈0.01）.The coincidence rate between the results of serological detection and the clinical manifestations was 55.3%.Conclusion Newborns,blood type of whom are not fit to the maternal,should receive serological examination within 2days after born.2days after born,the immunological type of blood group antibodies could be destroyed,which would cause false negative results and cause clinical misdiagnosis.