毛细管离心术在胎母血型不一致的临床大量FMH综合征的诊断价值

Massive Fetomaternal Hemorrhage Caused by Maternal-fetal Blood Type Inconsistency:Diagnostic Value of Capillary Centrifugation

目的探讨毛细管离心术对胎母血型不一致的大量FMH综合征高危孕产妇的辅助诊断价值和临床适用性。方法25例临床高度怀疑发生胎母血型不一致的大量FMH综合征的妊娠中晚期孕产妇,以流式细胞术结果为金标准评价毛细管离心术对临床大量FMH综合征的诊断效能。结果在出现典型FMH综合征临床表现的25例孕妇中,有15例经流式细胞术证实发生了大量胎母输血,有11例用毛细管离心术成功分离出血型不一致的胎儿红细胞血型。毛细管离心术诊断临床大量FMH综合征的敏感度为73.3%、特异度60%、阳性预测值73.3%、符合率68%。结论毛细管离心术对胎母血型不一致的大量FMH具有辅助实验诊断价值,因其简便易行可作为遗传学上可能有胎母血型不一致的大量FMH综合征的辅助诊断实验。

Objective To discuss the auxiliary diagnostic value of and clinical applicability of Capillary centrifugation in high-risk pregnant women with massive fetomaternal hemorrhage(FMH)caused by maternal-fetal blood type inconsistency.Methods Twenty-five pregnant women in the second-and third-trimester pregnancy suspected of massive FMH caused by maternal-fetal blood type inconsistency were enrolled.The results of flow cytometry were used as the gold standard to evaluate the diagnostic performance of capillary centrifugation.Results In the 25 pregnant women,15 cases were confirmed by flow cytometry to have undergone massive FMH,and 11 of them were successfully separated by Capillary centrifugation.The sensitivity,specificity,positive predictive value and coincidence rate of Capillary centrifugation for the diagnosis of massive FMH were 73.3%,60%,73.3%and 68%,respectively.Conclusion Capillary centrifugation has auxiliary experimental diagnostic value for massive FMH with maternal-fetal blood group incompatibility because it is simple and easy to operate.