溶血三项实验诊断新生儿ABO溶血病的价值

Value of Three Hemolytic Tests in the Diagnosis of Neonatal ABO Hemolytic Disease

目的:研究溶血三项实验诊断新生儿ABO溶血病(ABO HDN)的价值,为临床及时诊断ABO HDN提供有力的证据。方法:选择2018年1月-2020年12月在笔者所在医院检查的199例怀疑为ABO HDN患儿。所有患儿均行溶血三项试验。以临床确诊作为金标准,比较溶血三项实验诊断ABO HDN的价值。结果:199例怀疑为ABO HDN患儿有106例经临床确诊,其母子血型OA 68例,OB 38例。红细胞热放散试验的敏感度、准确度、阳性预测值、阴性预测值均高于直接抗人球蛋白试验、血浆抗体游离试验(P<0.05), 且血浆抗体游离试验的敏感度、准确度、阳性预测值、阴性预测值均高于直接抗人球蛋白试验(P<0.05)。直接抗人球蛋白试验的特异度高于红细胞热放散试验及血浆抗体游离试验(P<0.05)。结论:溶血三项试验中,红细胞热放散试验诊断ABO HDN的敏感度最高,可用于诊断新生儿ABO HDN。

Objective:To study the value of three hemolytic tests in the diagnosis of neonatal ABO hemolytic disease(ABO HDN),and to provide strong evidence for the timely clinical diagnosis of ABO HDN.Method:A total of 199 children with suspected ABO HDN examined in our hospital from January 2018 to December 2020 were selected.All children underwent three hemolytic tests.The clinical diagnosis was used as the gold standard,the value of three hemolytic tests in the diagnosis of ABO HDN was compared.Result:Among the 199 suspected ABO HDN children,106 cases were clinically confirmed,including 68 cases of OA and 38 cases of OB.The sensitivity,accuracy,positive predictive value and negative predictive value of erythrocyte thermal release test were higher than those of direct anti-human globulin test and plasma antibody free test(P<0.05).The sensitivity,accuracy,positive predictive value and negative predictive value of plasma antibody free test were higher than those of direct anti-human globulin test(P<0.05).The specificity of direct anti-human globulin test was higher than that of erythrocyte thermal release test and plasma antibody free test(P<0.05).Conclusion:Among the three hemolytic tests,erythrocyte thermal release test has the highest sensitivity in the diagnosis of ABO HDN,which can be used for the diagnosis of neonatal ABO HDN.