脐带血标本用于检测新生儿溶血三项的临床价值

Clinical value of umbilical cord blood for testing three index of neonatal hemolysis

目的：分析新生儿脐带血与静脉血对其溶血病（HDN）检测结果有无差异。方法：对O型孕妇（丈夫非O型）进行产前IgG溶血性抗体效价的测定,对效价≥1∶128的孕妇,在分娩时留取新生儿脐带血,同时采集出生后1～2天和3～4天、5～7天静脉血,进行新生儿溶血三项（直接抗人球蛋白试验、游离抗体试验和放散试验）检测并比较。结果：同一患儿脐带血与出生后1～2天采集静脉血检测结果无差异,与出生后3～4天、5～7天采集的静脉血检测结果差异有统计学意义。结论：脐带血和静脉血虽均可作为新生儿溶血病的检测,但脐带血阳性率高,而且取材方便,便于早诊断早治疗,可作为诊断HDN的首选标本。

[ Objective ] To analyze the differences of umbilical cord blood and veinal blood in testing neonatal hemolysis. [ Method] Prenatal determination of IgG antibody titer was tested in pregnant women with O - type blood （ husband with non - O）. For pregnant women with titer≥ 1 ： 128, newborn cord blood specimens were collected in childbirth, meanwhile veinal blood were collected 1 - 2 days, 3 - 4 days, 5 - 7 days after born. The direct anfiglobin test,indirect antiglobulin test and elu- tion test were carried out to detect neonatal hemolysis with above blood specimens. [ Result ] There are no difference between cord blood and veinal blood that collected 1 - 2 days after born. There are significant difference between cord blood and veinal blood that collected 3 - 4 days or 5 - 7 days after born. [ Conclusion] Although umbilical cord blood and venous blood can be used as the specimens for detection of hemolytic disease of the newborn, cord blood had higher positive rate and drawing conve- nience, ease of early diagnosis and treatanent. It can be used as the preferred diagnostic specimens.