血清B/A比值及血清总胆红素联合溶血三项试验对HDN的诊断价值

Diagnostic value of serum B/A ratio and serum total bilirubin combined with three hemolysis tests for HDN

目的探讨血清总胆红素/血浆清蛋白比值(B/A)及血清总胆红素联合溶血三项试验对新生儿溶血病(HDN)的诊断价值。方法选取2018年1月至2019年12月安徽省阜阳市人民医院收治的103例HDN患儿(HDN组)作为研究对象。根据HDN诊断标准及溶血三项试验结果,将HDN组又分为A、B、C、D组,另选取同期该院接受体检的健康新生儿100例作为非HDN组。HDN组均进行血清总胆红素水平及溶血三项试验检测,比较两组母亲相关资料并绘制受试者工作特征曲线分析血清总胆红素联合溶血三项试验诊断HDN的效能。结果HDN组中A组、C组、D组治疗后血清总胆红素水平均低于治疗前,差异均有统计学意义(P<0.05)。HDN组的母亲妊娠次数、血清碱性磷酸酶(ALP)水平、IgG抗体效价与非HDN组比较,差异均有统计学意义(P<0.05)。HDN患儿母亲妊娠次数>1次、HDN患儿母亲ALP水平≤174 U/L、HDN患儿母亲IgG抗体效价>1∶64、HDN患儿B/A比值均是HDN的独立危险因素(OR>1,P<0.05)。结论血清总胆红素联合溶血三项试验诊断HDN的价值较高,值得临床推广应用。

Objective To investigate the diagnostic value of serum B/A ratio and serum total bilirubin combined with hemolysis tests for hemolytic disease of newborn(HDN).Methods A total of 103 children with HDN(HDN group)admitted to Fuyang People′s Hospital of Anhui Province from January 2018 to December 2019 were selected as the study subjects.According to the diagnostic criteria of HDN and the results of three hemolysis tests,the HDN group was divided into groups A,B,C and D,and 100 healthy newborns who received physical examination in the hospital during the same period were selected as the non-HDN group.HDN group were tested by serum total bilirubin level and three hemolysis tests.The related data of the two groups of mothers were compared,and the working characteristic curve of the subjects was plotted to analyze the efficacy of serum total bilirubin combined with three hemolysis tests in the diagnosis of HDN.Results In the HDN group,the serum total bilirubin level in A,C and D group after treatment was lower than before treatment,with statistical significance(P<0.05).There were statistically significant differences in the number of pregnancies,ALP level and IgG antibody titer of mothers between the HDN group and the non-HDN group(P<0.05).The number of pregnancies of mothers with HDN children more than 1,the ALP level of mothers with HDN children≤174 U/L,the IgG antibody titer of mothers with HDN children>1∶64 and the B/A ratio of HDN children were all independent risk factors for HDN(OR>1,P<0.05).Conclusion Serum total bilirubin combined with hemolysis tests is of high value in the diagnosis of HDN,which is worthy of clinical application.