微柱凝胶技术在新生儿同种免疫性溶血病诊断中的临床应用

Clinical application of microcolumn gel technology in the diagnosis of neonatal immune hemolytic disease

目的探讨微柱凝胶技术直接抗人球蛋白试验对同种免疫性溶血病的可行性及发病原因的分析。方法采用微柱凝胶技术对1681例新生儿高胆红素血症患儿做直接抗人球蛋白试验。结果本研究1681例新生儿高胆红素血症患儿微柱凝胶技术直接抗人球蛋白试验阳性497例，阳性率为29．6％；ABO血型系统所致的同种免疫性溶血病491例，占98．8％（491／497），Rh血型系统所致的同种免疫性溶血病6例，占1．2％（6／497）。ABO血型系统中母亲O型，婴儿为A或B型476例，占96．9％（476／491），母／婴血型为A／B等其他配型15例，占3．1％（15／491）。结论直接抗人球蛋白试验与临床诊断符合率达90％以上，为新生儿溶血病提供实验室可靠诊断依据。

Objective To investigate the feasibility of microcolumn gel technology direct anti- globulin test in the autoimmune hemolytic disease, and to analyze the causes of autoimmune hemolytic disease. Methods One thousand six hundred and eighty-one cases of neonatal hyperbilirubinemia chil- dren taken the direct antiglobulin test by microcolumn gel technology. Results Among the 1681 cases of neonatal hyperbilirubinemi children, with microcolumn gel direct antiglobulin test positive in 497 cases, the positive rate was 29.6% ; with autoimmune hemolytic disease due to ABO blood group system 491 ca-ses, accounting for 98.8% （491/497） ; six cases of autoimmune hemolytic disease due to Rh blood group system, accounting for 1.2% （6/497）. O-ABO blood group system in the mother, the infant was type A or B of 476 ca-ses, accounting for 96.9% （476/491） ; The mother/infant blood group A/B, matching a total of 15 ca- ses, accounting for 3.1% （ 15/491 ）. Conclusions The accordance rate of direct antiglobulin test and clinical diagnosis was 90% or more, and direct antiglobulin test can provide reliable laboratory diagnostic basis for hemolytic disease of newborns.