新生儿溶血DAT三种检测方法的比较

Comparison of Three Methods in Detecting DAT of Hemolytic Disease of the Newborn

目的比较微柱凝胶卡式法、玻璃珠微柱卡式法和传统试管法对直接抗人球蛋白（DAT）的测定结果,探讨上述方法在新生儿溶血病（HDN）诊断中的应用价值。方法对242例疑似为ABO-HDN患儿的血液标本,分别采用微柱凝胶卡式法、玻璃珠微柱卡式法和传统试管法进行直接抗人球蛋白试验（直抗试验）。结果242份标本中,微柱凝胶卡式法、玻璃珠微柱卡式法和传统试管法对DAT的阳性检出率分别为34.7%（84/242）、64.5%（156/242）、27.3%（66/242）。三种方法两两比较,差异均有统计学意义（P〈0.05）。DAT阳性标本中,DAT凝集水平在1＋~2＋时,玻璃珠微柱卡式法检出率最高,三种方法两两比较,差异均有统计学意义（P〈0.05）;DAT凝集水平在3＋~4＋时,两种卡式法差异无统计学意义（P〉0.05）,分别与试管法比较,差异均有统计学意义（P〈0.05）。结论三种DAT检测方法中,玻璃珠微柱卡式法灵敏度最高,值得推广。

Objective To compare the direct anti-human globulin（DAT） results detected by micro-column gel card method, glass bead micro-column card method and traditional tube method, and to explore the value of methods above in diagnosing hemolytic disease of the newborn（HDN）. Methods 242 blood samples of children suspected of ABO-HDN received DAT by micro-column gel card method, glass bead micro-column card method and traditional tube method respectively. Results Of 242 specimens, the DAT positive rates of three methods above were 34.7%（84/242）, 64.5%（156/242） and 27.3%（66/242） respectively. Comparison of the three methods,the differences of any two were statistically significant（P 0.05）. Of the DAT positive samples, DAT aggregation level was between 1 ＋ and 2 ＋, detection rate of glass bead micro-column card method was highest, and differences of any two methods were statistically significant（P0.05）; DAT aggregation level was between 3＋ and4 ＋, and the difference of the two card methods was no statistically significant（P0.05）;however,compared with the test tube method, the differences were statistically significant（P0.05）. Conclusion Of the three methods on DAT detection, glass bead micro-column card method is of the highest sensitivity, worthy of promotion.