2种放散试验方法对于新生儿ABO溶血病检测的临床效果评价

Evaluation of clinical effects of two elution test methods for neonatal ABO hemolytic disease detection

目的比较冷冻复融放散试验和改良热放散试验（木瓜蛋白酶处理红细胞微柱凝胶卡法），对新生儿AB0溶血病的阳性检出率、灵敏度和特异度。方法选择2015年10月至12月于本院检验科接受新生儿ABO溶血病诊断检测的194份全血标本为研究对象。采用冷冻复融放散试验和改良热放散试验分别对其进行新生儿ABO溶血病检测。计算2种方法对新生儿ABO溶血病的阳性检出率、特异度及灵敏度，并且采用χ2检验对2种方法对新生儿ABO溶血病的阳性检出率进行统计学分析。结果冷冻复融放散试验对新生儿ABO溶血病的阳性检出率为57．7％（112／194），高于改良热放散试验的45．9％（89／194），二者比较，差异有统计学意义（χ2=5．46，P〈0．05）。冷冻复融放散试验对新生儿ABO溶血病检测的灵敏度为92．3％（72／78），高于改良热放散试验的76．9％（60／78）；这2种方法的特异度均为98．3％（57／58）。结论对于新生儿AB0溶血病的检测，冷冻复融放散试验和改良热放散试验均具有较高的特异度，但是冷冻复融试验灵敏度更高，更适合于该项目的临床应用。

Objective To compare the clinical application efficacy of frozen elution test and improved thermal elution test （papain-treated erythrocyte micro-column gel-card method） for neonatal ABO hemolytic disease detection, in order to select a laboratory diagnostic method with the best sensitivity and specificity in neonatal ABO hemolytic disease detection. Methods From October to December 2015, a total of 194 whole blood samples for neonatal ABO hemolytic disease detection were collected in this study. Frozen elution test and improved thermal elution test were used to detect all the samples for neonatal ABO hemolytic disease detection, respectively. The positive detection rate, specificity and sensitivity of these 2 methods for neonatal ABO hemolytic disease detection were calculated, and the positive detection rate of the 2 methods for neonatal ABO hemolytic disease detection was compared by Chi-square test. Results The positive detection rate of frozen elution test for neonatal ABO hemolytic disease detection was 57.7% （112/194）, which was higher than that of 45. 9% （89/194） of improved thermal elution test, and the difference of positive detection rates in these 2 methods was statistically significant （χ2 = 5.46, P〈0.05）. The sensitivity of the frozen elution test for neonatal ABO hemolytic disease detection was 92. 3%（72/78）, which was higher than that of 76.9% （60/78） of improved thermal elution test. The specificity of the 2 methods was both 98.3% （57/58）. Conclusions Frozen elution test and improved thermal elution test were both with high specificity for neonatal ABO hemolytic disease detection. However, the sensitivity of frozen elution test is higher and more suitable for the clinical application of this project.