3160例高胆红素血证新生儿溶血病实验室检测结果分析

Analysis of laboratory test results of 3 160 cases of hemolytic disease of newborn in Ningde city

目的:分析新生儿溶血病(HDN)血清学检测结果并探讨与性别、血型、送检日龄的关系。方法:采用微柱凝胶法对3 160例高胆红素血证新生儿的血样进行HDN 3项试验(直接抗人球蛋白试验、游离抗体试验、抗体释放试验)检测,并分析HDN阳性率与性别、血型、送检日龄的关系。结果:3 160例高胆红素血证新生儿证实为HDN的有595例,阳性率为18.83%。3项试验中,抗体释放试验敏感性最高,阳性率为99.66%(593/595),其次为游离抗体试验,阳性率为80.0%(476/595),直接抗人球蛋白试验最低,阳性率仅为11.09%(66/595)。女性患儿HDN阳性率明显高于男性患儿(χ~2=22.07,P<0.05)。A型与B型新生儿HDN阳性率差异无统计学意义(χ~2=0.37,P>0.05)。HDN阳性率与送检日龄密切相关,日龄越小阳性率越高,差异有统计学意义(P<0.05)。结论:高胆红素血证新生儿HDN阳性率较高,与新生儿性别、送检日龄密切相关,A型与B型的发病率无显著差异。采用微柱凝胶法进行HDN 3项试验,敏感性高,有助于HDN的早期诊断、早期治疗。

Objective：To analyze serological test results of hemolytic diseases of newborn（HDN）and to explore its related factors. Method：The neonatal hemolytic three hemolysis tests （direct antiglobulin test, free antibody test and antibody release test） were performed by using micro column gel method , 3 160 cases of neonatal hyper- bilirubinemia blood specimens were tested, The relationship between the positive rate of HDN with the related factors such as gender, blood type, the specimens collecting time were analyzed. Result： Among 3 160 cases of hyper- bilirubinemia, 595 cases were confirmed for HDN, the positive rate was 18. 83 %. The sensitivity of antibody re- lease test was the highest in the three hemolysis tests, positive rate was 99.66% （593/595）, followed by free an- tibody test, positive rate was 80.0% （476/595）, direct antiglobulin test was the lowest, the positive rate was on- ly 11.09% （66/595）. The HDN positive rate of female neonatal was higher than male neonatal significantly（χ2= 22.07 ,P〈0.05）. The HDN positive rate was no significant difference between A blood type and B blood type neo- natal （χ2= 0. 37, P〈0.05）. The HDN positive rate was closely related with the specimen collection time, the smaller the day age ,the higher the HDN positive rate, the difference showing statistical significance （P〈0.05）. Conclusion：The positive rate of HDN is high in neonatals with hyperbilirubinemia,it has certain relations with neo- natal gender, mainly in neonatal with blood type A/B, but there is no significant difference between A blood type and B blood type,closely related with the specimen collection time, the smaller the day age , the higher the positive rate. The sensitivity of three hemolysis test is high by using micro column gel method. Three hemolysis tests are helpful in early diagnosis and early treatment of HDN.