溶血三项检测血清总胆红素及IgG抗体效价与新生儿ABO溶血病的关系探讨

Analysis of the relationship between three hemolysis tests,serum total bilirubin and IgG antibody titer and ABO hemolytic disease of newborn

目的分析新生儿溶血相关实验室检测结果,探讨常规实验室检测指标对新生儿溶血诊断的参考意义。方法选取2017年4月-2019年3月广州市妇女儿童医疗中心新生儿病区收治的疑似新生儿溶血病患儿563例,通过检测新生儿及其母亲血清相关指标,探讨溶血三项试验、血清总胆红素水平以及IgG抗体效价与ABO-HDN相关性。结果溶血三项试验显示,判定新生儿溶血阳性总检出率为31.62%,其中A型血比例大于B型血,释放试验阳性检出率最高;溶血阳性患儿与溶血阴性新生儿相比,血清总胆红素水平明显升高,且三项试验均为阳性的患儿血清胆红素水平升高幅度最大,差异有统计学意义(P<0.05);母亲IgG抗体效价值越大,新生儿ABO-HDN发生率越高;新生儿不同IgG抗体效价越高,新生儿血清总胆红素水平呈偏高趋势(P<0.05)。结论溶血三项试验、血清总胆红素测定以及抗体效价分析是新生儿溶血检测的重要评价体系,尽早采取相应措施预防新生儿溶血。

Objective To explore the reference significance of routine laboratory test indexes for hemolysis diagnosis of newborns by analyzing the results of hemolysis related laboratory test.MethodsFrom April 2017 to March 2019,563 children suspected of hemolytic disease were selected from the Newborn Ward of Guangzhou Women and Children Medical Center.The correlation between three hemolytic tests,serum total bilirubin level,IgG antibody titer and ABO-HDN was studied by detecting the serum related indicators of the newborns and their mothers.ResultsThree hemolysis tests showed that the total detection rate of hemolysis positive was 31.62%,in which the proportion of type A blood was higher than that of type B blood,and the detection rate of release test was the highest;compared with the hemolysis negative newborns,the level of total bilirubin in serum of hemolysis positive newborns was significantly higher,and the increase of the level of bilirubin in serum which showed positive in all three tests was the highest and the difference was statistically significant(P<0.05);The higher value of mother′s IgG antibody,the higher incidence rate of ABO-HDN;the higher the titer of baby′s IgG antibody,the higher the level of total bilirubin(P<0.05).ConclusionThree tests of hemolysis,determination of total bilirubin in serum and analysis of antibody titer are important evaluation systems for hemolysis test of the newborns.And we should take corresponding measures as early as possible to prevent hemolysis of them.