碳氧血红蛋白及网织红细胞在新生儿溶血病诊断中的应用价值

Application value of carboxyhemoglobin and reticulocyte in the diagnosis of hemolytic disease of newborn

目的探讨碳氧血红蛋白(COHb)联合网织红细胞(Ret)对新生儿溶血病(HDN)的诊断价值。方法选取我院2018年11月至2019年4月收治的286例HDN患儿,将其作为HDN组;选取同期于我院分娩的286例健康新生儿作为对照组。比较两组血清COHb、Ret水平;绘制受试者工作特征曲线(ROC),分析血清COHb、Ret及二者联合诊断HDN的价值,获得曲线下面积(AUC),明确最佳截断值、灵敏度及特异度。结果HDN组的血清COHb、Ret水平高于对照组(P<0.05)。ROC曲线提示,血清COHb、Ret单独诊断HDN的AUC分别为0.599、0.616,最佳截断值分别为1.308%、4.855%。COHb联合Ret诊断HDN的灵敏度为86.4%,特异度为75.2%。结论HDN患儿的血清COHb、Ret水平明显较高,且COHb联合Ret对HDN具有较高的诊断价值。

Objective To explore the diagnostic value of carboxyhemoglobin(COHb)combined with reticulocyte(Ret)in hemolytic disease of newborn(HDN).Methods A total of 286 children with HDN admitted in our hospital from November 2018 to April 2019 were selected as HDN group,and 286 healthy newborns delivered in our hospital during the same period were selected as control group.The levels of COHb and Ret were compared between the two groups.The diagnostic value of serum COHb,Ret and combination for HDN were analyzed by drawing the receiver operator characteristic(ROC)curve.The area under the curve(AUC)were obtained,and the optimal truncation value,sensitivity and specificity were determined.Results The serum COHb and Ret levels in the HDN group were higher than those in the control group(P<0.05).The ROC curve indicated that the AUC of serum COHb and Ret for diagnosis of HDN was 0.599,0.616 respectively,the optimal truncation value was 1.308%,4.855%respectively.The sensitivity and specificity of COHb combined with Ret in the diagnosis of HDN were 86.4%and 75.2%respectively.Conclusion The levels of COHb and Ret in serum of children with HDN are significantly higher,and COHb combined with Ret had higher diagnostic value for HDN.