直接抗人球蛋白试验预测Rh血型不合新生儿溶血病能力的研究

Predictive ability of direct antibody test in infants with Rh incompatibility hemolytic disease of newborn

目的新生儿溶血病常发生于母婴血型不合的新生儿,有些患儿会发生严重的高胆红素血症,早期识别高危新生儿非常重要。本研究采用直接抗人球蛋白试验预测Rh血型不合新生儿溶血病治疗指征。方法对2015年10月-2017年7月送检至输血科的疑似新生儿溶血病患儿进行回顾性研究。分析患儿DAT结果与患儿是否达到治疗指征之间的关系。结果 DAT阳性预测新生儿溶血符合治疗指征的灵敏度和特异度分别为92.3%和81.8%;阳性预测值和阴性预测值分别为85.7%和90.0%。结论当新生儿母亲血清中有有临床意义的抗体,患儿有发生Rh血型不合溶血病风险时,新生儿DAT结果能够很好的预测其是否符合高胆红素血症的治疗指征。

Objective Hemolytic disease of the newborn（ HDN） most commonly occurs in neonates whose red blood cell（ RBC） antigen is incompatibility with her mother. Because affected neonates may develop severe hyperbilirubinemia,early identification of at-risk neonates is critically important. The direct antibody test（ DAT） was used to predict the treatment criteria for Rh incompatibility HDN. Methods A retrospective review was conducted on the suspected neonatal hemolytic disease at our Blood Transfusion Department during October 2015 to July 2017. The relationship between the child’ s DAT results and whether the neonates achieved treatment indications was analyzed. Results The sensitivity and specificity of a positive DAT result for meeting the treatment criteria was 92. 3% and 81. 8%,respectively. The positive and negative predictive value was85. 7% and 90. 0%,respectively. Conclusion When there is a clinically significant antibody in the serum of a newborn mother,and the neonates has a risk of Rh blood group incompatibility,the result of a DAT is a specific marker with good positive predictive value for identifying those who are most likely to meet the treatment criteria for hyperbilirubinemia in neonates at risk for Rh-HDN.