267例新生儿ABO溶血病血清学实验结果分析

Analysis of Serologic Experimental Results of 267 Cases of Newborns with ABO Hemolytic Disease

目的探讨分析新生儿ABO溶血病血清学检测结果。方法选取2013年12月—2015年12月在该院出生的267例新生儿溶血病患儿,采用盐水法检测ABO血型,微柱凝胶试验技术对患儿做直接抗人球蛋白试验、红细胞抗体释放试验、血清游离抗体试验,着重观察新生儿溶血病与血型的关系,3项试验检测的阳性率及血液采集时间与新生儿ABO溶血病检测阳性率的关系。结果 267例新生儿ABO溶血病患儿中,总阳性率83.52%,其中A型阳性率87.82%,明显高于B型的76.58%,两组比较差异有统计学意义（P〈0.05）。女患儿HDN的阳性检出率高于男患儿,差异具有统计学意义（P〈0.05）。患儿采血时间在1~7 d内的新生儿ABO溶血病检测阳性率为89.14%,明显高于7~14 d的71.74%,两组差异有统计学意义（P〈0.05）。结论新生儿溶血病以A型婴儿发病率高于B型婴儿;新生儿溶血病血清学试验检测中,红细胞抗体释放试验阳性率最高,直接抗人球蛋白试验阳性率最低;尽早采集患儿的血液标本行血清学检测能提高新生儿ABO溶血病的确诊率。

Objective To study and analyze the serologic test results of newborns with ABO hemolytic disease. Methods 267 cases of newborns with hemolytic disease born in our hospital from December 2013 to December 2015 were selected, and the ABO blood types of them were tested by the saline method, and we do the direct anti-human-globulin test, erythro-cyte-antibody release test and serum free antibody test for children by microcolumn gel test technology, and the correlation between the hemolytic disease of newborns and blood style and correlation between the positive rates of the three tests and blood collection time and positive rate of ABO hemolytic disease in newborns were especially observed. Results The total positive rate of 267 cases of newborns with ABO hemolytic disease was 83.52%, the positive rate in newborns with A style was obviously higher than that in newborns with B style, and the difference between groups had statistical significance by comparison, （87.82% vs 76.58%）（P〈0.05）, the positive detection rate of HDN in female children was higher than that in the male children, and the difference had statistical significance （P〈0.05）, the test positive rate of ABO hemolytic disease in newborns whose blood collection time was between 1d and 7 d was obviously higher than that in newborns whose blood col-lection time was between 7 d and 14 d, and the difference between groups had statistical significance （P〈0.05）. Conclusion The morbidity of A type infants with hemolytic disease is higher than that of B type infants with hemolytic disease, the posi-tive rate of erythrocyte-antibody release in the serologic test of hemolytic disease in newborns is the highest and the posi-tive rate of direct antiglobulin test is the lowest, and we can improve the diagnosis rate of ABO hemolytic disease in new-borns by serologic test that needs to collect blood specimens of children as soon as possible.